Invoice Doctor General Practitioner in France Lyon –Free Word Template Download with AI
15 Rue de la République
69002 Lyon, France
Tel: +33 4 72 00 00 00
Email: [email protected]
RPPS: 10004567890
SIRET: 123 456 789 00012
TVA Intracommunautaire: FR 12 123456789
INVOICE
Date: October 24, 2023
Invoice #: LY-2023-10-045
Bill To (Patient)
Mr. Thomas Dubois
42 Avenue Jean Jaurès
69007 Lyon, France
Social Security Number: 1 85 04 75 001 234 56
CPAM: Lyon (69)
| # | Description of Medical Services | Code (Nomenclature) | Qty | Unit Price (€) | Total (€) |
|---|---|---|---|---|---|
| 1 |
General Consultation Comprehensive medical examination and diagnosis provided by the Doctor General Practitioner in Lyon. Includes review of medical history, physical examination, and initial treatment plan. |
20004 | 1 | 25.00 | 25.00 |
| 2 |
Medical Certificate Issuance of an official medical certificate for employment or administrative purposes, signed by the licensed Doctor General Practitioner in France. |
20010 | 1 | 15.00 | 15.00 |
| 3 |
Home Visit (Domiciliary Care) Emergency home visit conducted by the Doctor General Practitioner within the Lyon metropolitan area due to patient immobility. Includes travel time and on-site assessment. |
20005 | 1 | 45.00 | 45.00 |
| 4 |
Specialized Follow-up Detailed follow-up consultation for chronic condition management. Includes adjustment of medication and coordination with specialists in Lyon hospitals. |
20006 | 1 | 30.00 | 30.00 |
| 5 |
Administrative Fee Processing fee for insurance claims submission to CPAM Lyon and supplementary mutual insurance providers. |
ADM-01 | 1 | 5.00 | 5.00 |
Important Notes & Terms
This invoice represents the fees charged by the Doctor General Practitioner for medical services rendered in Lyon, France. All prices are in Euros (€).
Insurance Information: As per French healthcare regulations, the base rate for consultations is set by the national health insurance (Sécurité Sociale). The CPAM Lyon will reimburse 70% of the base rate. The remaining 30% is the patient's responsibility, often covered by supplementary private insurance (Mutuelle).
Payment Terms: Payment is due within 7 days of the date of service. Late payments may incur a penalty fee of 3 times the legal interest rate. Please reference the invoice number LY-2023-10-045 when making payments.
Legal Compliance: This invoice complies with the French Public Health Code and the General Tax Code. The Doctor General Practitioner is registered with the Lyon Medical Council (Ordre des Médecins de Lyon).
Contact: For any questions regarding this invoice or your medical records, please contact our office in Lyon during business hours (Monday to Friday, 8:00 AM - 6:00 PM).
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