Invoice Midwife in South Africa Johannesburg –Free Word Template Download with AI
Registered Midwife Services
123 Sandton Drive, Sandton
Johannesburg, 2196
South Africa
SACNASP Registration: M12345678
Tax Number: 4560123456
Email: [email protected]
Phone: +27 11 555 0199
Bill To:
Mrs. Sarah van der Merwe
45 Oak Avenue, Bryanston
Johannesburg, 2021
South Africa
Medical Aid: Discovery Health (Plan: Premier)
Member Number: 987654321
Dependent Number: D-112233
Service Period & Reference:
Service Period: 01 September 2023 – 23 October 2023
Patient Name: Sarah van der Merwe
Estimated Due Date: 15 November 2023
Service Type: Comprehensive Antenatal & Midwifery Care
Location: Private Practice, Johannesburg CBD
| # | Description of Midwifery Services | Quantity | Unit Price (ZAR) | Total (ZAR) |
|---|---|---|---|---|
| 1 |
Initial Antenatal Consultation & Risk Assessment Comprehensive intake interview, medical history review, and initial physical examination conducted in accordance with South African National Department of Health guidelines. Includes discussion of birth preferences and creation of a personalized care plan. |
1 | R 1,200.00 | R 1,200.00 |
| 2 |
Routine Antenatal Visits (Sessions 2-6) Five scheduled midwifery appointments for monitoring fetal development, maternal blood pressure, weight gain, and urine analysis. Includes education on nutrition, exercise, and signs of labor specific to the Johannesburg healthcare context. |
5 | R 850.00 | R 4,250.00 |
| 3 |
Fetal Heart Rate Monitoring & Growth Scans Coordination Doppler monitoring sessions and coordination with radiologists for ultrasound scans at accredited facilities in the Gauteng province. Review of scan results and counseling regarding fetal well-being. |
3 | R 450.00 | R 1,350.00 |
| 4 |
Antenatal Education Workshop Attendance at a group session covering labor stages, pain management techniques, breastfeeding initiation, and newborn care. Held at the Jozi Maternity Care center in Johannesburg. |
1 | R 600.00 | R 600.00 |
| 5 |
Home Visit: Third Trimester Preparation In-home assessment to evaluate the birthing environment, check emergency preparedness, and provide reassurance. Travel within the Johannesburg metropolitan area included. |
1 | R 950.00 | R 950.00 |
| 6 |
Administrative & Medical Aid Claim Processing Preparation and submission of medical claims to Discovery Health, including coding of midwifery services according to the Medical Schemes Act of South Africa. |
1 | R 350.00 | R 350.00 |
Payment Instructions
Please settle the balance due by the due date indicated above. Payments can be made via Electronic Funds Transfer (EFT) to the following bank account:
Bank: First National Bank (FNB)
Account Name: Jozi Maternity Care (Pty) Ltd
Account Number: 62012345678
Branch Code: 250655
Reference: INV-2023-10-045
Note: Please ensure your medical aid has been billed separately as per the estimate above. This invoice reflects the patient's portion of the fees.
Terms and Conditions
- All services are rendered by a registered Midwife in good standing with the South African Council for Natural Scientific Professions (SACNASP).
- Prices are quoted in South African Rand (ZAR) and are subject to 15% Value Added Tax (VAT) as per South African tax law.
- Medical aid claims are submitted on behalf of the patient but are subject to the specific benefits and limits of the patient's medical scheme.
- Payment is due within 30 days of the invoice date. Late payments may incur a monthly interest charge of 5%.
- In the event of an emergency delivery outside of scheduled hours, additional on-call fees may apply as per the agreed service contract.
- This invoice serves as a formal record of midwifery care provided in Johannesburg, South Africa, and should be retained for your personal medical records.
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