Only tick “Invoice on arrival” & “Adjust at this appointment” for appointments where you want the patient to be billed for two different items – e.g. Re-Exam and Adjustment. Both are billing items. If you set this to Adjustment for the Adjustment appointment type, the patient will be billed for Adjustment twice!
You can also delete appointment templates that are not being used. If the template is in use you will be given the option to merge the appointment template with another.