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Invoice Doctor General Practitioner in France Paris –Free Word Template Download with AI

SECTOR 1 PRACTITIONER

15 Rue de la Paix
75002 Paris, France
Tel: +33 1 42 60 00 00
Email: [email protected]

RPPS: 10004567890
SIRET: 823 456 789 00012
TVA Intracommunautaire: FR 12 823456789

INVOICE

Invoice Number: INV-2023-10-045

Date of Issue: October 24, 2023

Date of Service: October 24, 2023

Due Date: Upon Receipt

Bill To (Patient) Monsieur Thomas Martin
42 Avenue des Champs-Élysées
75008 Paris, France
Social Security Number (NIR):
1 85 02 750 123 456 78
CPAM: CPAM Paris
Mutuelle: Groupama Santé
Medical Services Rendered
Code (NGAP) Description of Service Qty Unit Price (€) Total (€)
200 Standard Consultation
Consultation with a Doctor General Practitioner for general medical assessment, diagnosis, and treatment plan formulation.
1 25.00 25.00
201 Extended Consultation
Consultation lasting more than 20 minutes involving complex medical history review and multidisciplinary coordination.
1 38.00 38.00
204 Home Visit (Paris Intra-muros)
Medical visit performed at the patient's residence within the Paris city limits due to patient immobility.
1 45.00 45.00
206 Medical Certificate
Issuance of an official medical certificate for employment or administrative purposes in France.
1 15.00 15.00
209 Minor Surgical Procedure
Suture of a minor laceration on the forearm, including local anesthesia and dressing application.
1 55.00 55.00
Subtotal (Hors Taxe) 178.00 € VAT (TVA 20%) 35.60 € CPAM Reimbursement (70%) -124.60 € Mutuelle Contribution -18.00 € Amount Due by Patient 71.00 € Payment Instructions

Please remit payment via bank transfer or credit card. For bank transfers, please use the following details:

Bank: BNP Paribas, Paris
IBAN: FR76 3000 4000 0000 0000 0000 1
BIC: BNPAFRPP
Reference: INV-2023-10-045

Important Notes & Legal Information

This invoice represents the fees charged by the Doctor General Practitioner for medical services rendered in Paris, France. The pricing structure adheres to the National Agreement on Professional Fees (NGAP) applicable to Sector 1 practitioners in the French healthcare system.

Reimbursement Policy: In France, the primary health insurance fund (CPAM) typically reimburses 70% of the standard fee for a general practitioner consultation. The remaining balance is often covered by supplementary health insurance (Mutuelle). The amounts deducted above are estimates based on standard reimbursement rates and may vary depending on the patient's specific insurance contract.

Home Visits: Home visits within Paris are subject to specific fee codes due to the logistical requirements and travel time involved. These fees are fully recognized by the French social security system.

Data Protection: In accordance with the General Data Protection Regulation (GDPR) and French health data laws (HDS), all personal and medical information contained in this invoice is strictly confidential and will be processed solely for billing and medical record-keeping purposes.

Disputes: Any discrepancies regarding this invoice should be reported within 30 days of the date of issue. Please contact the medical secretary at the address listed above.

This document serves as a formal request for payment for medical services provided. The Doctor General Practitioner guarantees the professional quality of the care provided in accordance with the ethical code of the French Medical Council (Conseil National de l'Ordre des Médecins). This invoice is valid for tax purposes and can be used for reimbursement claims with your insurance provider. By accepting the medical services, the patient acknowledges the terms of the standard medical practice in France.

Thank you for your trust in our medical practice located in the heart of Paris. We remain at your disposal for any further medical needs.

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