Invoice Ophthalmologist in Australia Brisbane –Free Word Template Download with AI
Dr. Sarah Jenkins, FRANZCO
Consultant Ophthalmologist
ABN: 12 345 678 901
Medical Board of Australia Registration: 123456
Invoice Number: INV-2023-10-045
Date Issued: 24 October 2023
Due Date: 24 November 2023
Reference: Patient ID #998877
Bill To (Patient)
Mr. James Anderson
42 River Terrace
New Farm, QLD 4005
Australia
Phone: +61 7 3333 4444
Email: [email protected]
From (Provider)
Brisbane Specialist Eye Care
Suite 5, Level 2
123 Queen Street
Brisbane CBD, QLD 4000
Australia
Phone: +61 7 3123 4567
Email: [email protected]
Dear Mr. Anderson,
This document serves as an official Invoice for the professional medical services rendered by our Ophthalmologist, Dr. Sarah Jenkins. These services were provided at our clinic located in the heart of Australia Brisbane. As a leading provider of comprehensive eye care in Queensland, we are committed to delivering high-quality ophthalmic services, ranging from routine examinations to complex surgical interventions.
Please review the details below regarding your recent consultation and treatment. This Invoice outlines the costs associated with your visit, including Medicare rebates where applicable, and any out-of-pocket expenses you are liable for.
| # | Description of Ophthalmology Services | Medicare Item No. | Total Fee (AUD) | Medicare Rebate (AUD) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmic Examination Detailed assessment of visual acuity, intraocular pressure, and retinal health performed by a specialist Ophthalmologist. Includes slit-lamp biomicroscopy and dilated fundus examination. |
23 | $250.00 | $85.00 |
| 2 |
Optical Coherence Tomography (OCT) Advanced imaging of the retina and optic nerve head to detect early signs of macular degeneration and glaucoma. Essential diagnostic tool in modern ophthalmology. |
73301 | $150.00 | $65.00 |
| 3 |
Prescription of Corrective Lenses Provision of prescription for spectacles following refraction testing. |
N/A | $50.00 | $0.00 |
| 4 |
Management of Dry Eye Syndrome Consultation and treatment plan formulation for chronic dry eye, including prescription of lubricating drops and anti-inflammatory medication. |
23 | $120.00 | $45.00 |
| Subtotal (Total Fees) | $570.00 |
| Less: Medicare Rebates | -$195.00 |
| Out-of-Pocket Amount Due | $375.00 |
Payment Instructions
Please remit payment for the outstanding balance of $375.00 AUD by the due date indicated above. We accept various payment methods to ensure convenience for our patients in Australia Brisbane.
- Bank Transfer (BSB/Account): 082-123 / 45678901 (Brisbane Specialist Eye Care Pty Ltd)
- Credit Card: Please contact our billing department to arrange payment over the phone.
- In-Person: Payments can be made at our reception desk in Brisbane CBD.
Please quote your Invoice Number (INV-2023-10-045) and your name when making a payment to ensure accurate allocation of funds.
Important Notes Regarding Your Ophthalmology Invoice
1. Medicare Rebates: The Medicare rebates listed on this Invoice are estimates based on current government schedules. Actual rebates may vary slightly depending on your individual Medicare status and whether you have already claimed your annual limit for certain items. If you have a private health fund that covers ophthalmology services, please contact them directly for further rebates.
2. Specialist Services: As a specialist Ophthalmologist, Dr. Jenkins provides advanced medical and surgical care for eye conditions. Fees reflect the specialized training, expertise, and advanced technology utilized in our Brisbane clinic.
3. Late Payments: If payment is not received by the due date, a late fee of 1.5% per month may be applied to the outstanding balance. Persistent non-payment may result in the account being referred to a debt collection agency.
4. Disputes: If you believe there is an error on this Invoice, please contact our billing department within 14 days of the invoice date. We are committed to resolving any discrepancies promptly and fairly.
5. Privacy: Your personal and medical information is handled in accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles. We ensure the highest standards of confidentiality for all patients in Australia Brisbane.
Thank you for choosing Brisbane Specialist Eye Care for your ophthalmology needs. We appreciate your trust in our services and look forward to continuing to care for your eye health.
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