Which of the following is NOT a major deduction from accounts receivables?

The option identified as the correct answer, which is not a major deduction from accounts receivables, is service refunds. This is because deductions from accounts receivable typically encompass amounts that truly represent a reduction in the value expected to be collected from patients or insurers.

Bad debt refers to amounts that are unlikely to be collected, which directly impacts the accounts receivable balance as it signifies a loss of revenue. Charity accounts represent situations where services are provided at reduced or no charge due to financial constraints of the patient, thus impacting the receivable amount. Insurance adjustments occur when the amount billed differs from the amount allowed by the insurance provider, requiring adjustments that reflect the actual collectible amount.

On the other hand, service refunds are generally transactions where money is returned to a patient after payment has been processed, and these adjustments often take a different accounting treatment compared to the main deductions that reduce the expected collectible value of accounts receivables. Hence, service refunds do not directly affect the receivables in the same manner as the other options listed.