> ## Documentation Index > Fetch the complete documentation index at: https://help.elationhealth.com/llms.txt > Use this file to discover all available pages before exploring further. # Elation EHR + Billing - Integrated Refunds > Learn how to process patient refunds that sync between EHR and Elation Billing This article explains how to process patient refunds in the EHR with automatic updates to Elation Billing. ## Overview ### What are Integrated Refunds? In the EHR, using **Refund** or **Mark Refunded** will apply the following changes in Elation Billing: * Update the Payment amount to \$0 * Update the Check Number to **Refunded** It will NOT update or remove any Superbills that have been added to the Payment. ## Workflow Instructions ### Processing a Refund 1. **Navigate to Patient Payment Report** - In the EHR (not Elation Billing), navigate to **Reports** → **Patient Payment Report**. 2. **Refund or Mark Refunded** - Once you've found the Patient Payment you wish to refund, use the Actions button: ### For Cash/Check Payments → Mark Refunded A zoomed-in view of the previous image, focused on the Mark Refunded option ### For Credit Card Payments → Refund Image 3. **Review in Elation Billing** - Verify the refund was processed correctly. ### Before the Refund The payment will look something like this: Payment #761. It has a value of $100, no Check Number, and has been fully applied to Superbill 464 ### After the Refund * The Check # has been updated to **Refunded** * The Payment amount has been updated to \$0 * The Unapplied amount will represent the amount that is now over-applied to any Superbills Payment #761. Now refunded, it has a Payment of $0. The Check # is now Refunded ## Related Articles * [Elation EHR + Billing - Collecting a Patient Payment in the EHR](/articles/elation-ehr-billing-collecting-a-patient-payment-in-the-ehr) * [Clearing Out a Payment](/articles/clearing-out-a-payment)