Invoice Midwife in Israel Tel Aviv –Free Word Template Download with AI
Professional Midwife: Sarah Cohen, RN, IBCLC
License No.: 123456789
Address: 45 Allenby Street, Tel Aviv-Yafo, Israel 67890
Phone: +972-3-555-1234
Email: [email protected]
VAT ID: 512345678
Invoice Number: INV-2024-0892
Date Issued: October 15, 2024
Due Date: November 15, 2024
Service Period: September 1, 2024 - October 14, 2024
PENDING PAYMENTBill To:
Client Name: Rachel & David Levi
Address: 12 Herzl Street, Apartment 4B
Tel Aviv-Yafo, Israel 64710
ID Number: 312345678
Phone: +972-50-555-9876
Email: [email protected]
Insurance Provider: Maccabi Healthcare Services
Policy Number: MAC-2024-789456
Group ID: GRP-TLV-456
Claim Reference: CLM-2024-1234
| # | Description of Midwifery Services | Date | Hours | Rate (ILS) | Amount (ILS) |
|---|---|---|---|---|---|
| 1 |
Initial Prenatal Consultation & Care Plan Development Comprehensive assessment of maternal health history, risk evaluation, and personalized birth plan creation in accordance with Israeli Ministry of Health guidelines. Includes nutritional counseling and emotional support strategies. |
2024-09-05 | 2.0 | 350.00 | 700.00 |
| 2 |
Regular Prenatal Visits (Sessions 1-6) Ongoing midwifery care including fetal heart rate monitoring, blood pressure checks, fundal height measurements, and education on pregnancy milestones. Conducted at client's residence in Tel Aviv. |
2024-09-12 to 2024-10-10 | 6.0 | 300.00 | 1,800.00 |
| 3 |
Birth Preparation Workshop Group session covering labor stages, breathing techniques, pain management options, and postpartum expectations. Held at Shalom Midwifery Center, Tel Aviv. |
2024-09-20 | 3.0 | 250.00 | 750.00 |
| 4 |
Ultrasound Coordination & Results Interpretation Assistance with scheduling diagnostic ultrasounds at Sheba Medical Center and providing professional interpretation of results with appropriate referrals when necessary. |
2024-09-25 | 1.5 | 350.00 | 525.00 |
| 5 |
Lactation Consultation & Breastfeeding Support Specialized IBCLC-certified session addressing breastfeeding techniques, latch correction, and milk supply optimization. Includes follow-up phone consultation. |
2024-10-02 | 1.5 | 400.00 | 600.00 |
| 6 |
Postpartum Home Visit Package (3 Visits) Comprehensive newborn care assessment, maternal recovery monitoring, umbilical cord care guidance, and emotional well-being check. Includes provision of essential newborn care supplies. |
2024-10-08 to 2024-10-14 | 4.5 | 320.00 | 1,440.00 |
| 7 |
Emergency On-Call Availability Fee 24/7 telephone and emergency response coverage throughout the pregnancy period as per Israeli midwifery standards. |
2024-09-01 to 2024-10-14 | - | Flat | 800.00 |
| 8 |
Medical Documentation & Insurance Coordination Preparation of all required medical records, birth certificates documentation, and coordination with Clalit/Maccabi health funds for reimbursement processing. |
2024-10-15 | 1.0 | 200.00 | 200.00 |
| Subtotal: | 6,815.00 ILS |
| Discount (Early Payment): | -340.75 ILS |
| Taxable Amount: | 6,474.25 ILS |
| VAT (17%): | 1,100.62 ILS |
| TOTAL DUE: | 7,574.87 ILS |
Payment Instructions
Bank Name: Bank Hapoalim, Israel
Branch: Tel Aviv Central, Branch #1234
Account Name: Shalom Midwifery Services Ltd.
Account Number: 987654321
SWIFT/BIC: POALILIT
IBAN: IL989876543210000000
Reference: Please include Invoice Number INV-2024-0892
Payment is due within 30 days of invoice date. Late payments will incur a 1.5% monthly interest charge as per Israeli commercial law. For international payments, please contact our office to arrange alternative payment methods.
Important Notes & Terms
1. Service Coverage: All midwifery services provided are in accordance with the regulations set forth by the Israeli Ministry of Health and the Israel Midwives Association. Our services cover the Tel Aviv metropolitan area and surrounding communities.
2. Insurance Reimbursement: This invoice may be submitted to your health maintenance organization (HMO) for partial or full reimbursement depending on your coverage plan. We recommend contacting Maccabi Healthcare Services directly to verify your benefits.
3. Confidentiality: All medical information and personal data are handled in strict accordance with Israeli privacy laws and medical confidentiality standards.
4. Dispute Resolution: Any disputes regarding this invoice shall be resolved through mediation in Tel Aviv, Israel, in accordance with Israeli law.
5. Contact Information: For any questions regarding this invoice or the services provided, please contact Sarah Cohen directly at +972-3-555-1234 or via email at [email protected]. Office hours are Sunday through Thursday, 9:00 AM to 5:00 PM (Israel Standard Time).
6. Thank You: We appreciate your trust in our midwifery services and are honored to have been part of your family's journey. Wishing you and your newborn health, happiness, and shalom.
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