Invoice Ophthalmologist in Germany Berlin –Free Word Template Download with AI
Specialist Ophthalmologist
Charlottenburger Str. 45
10585 Berlin, Germany
Tel: +49 (0)30 1234 5678
Email: [email protected]
USt-IdNr.: DE123456789
Invoice No: INV-2023-10-045
Date: October 24, 2023
Due Date: November 24, 2023
Reference: Patient ID #8842-B
Bill To (Patient)Mr. Thomas Schmidt
Kurfürstendamm 120
10711 Berlin, Germany
Germany
Insurance / Payer DetailsAOK Berlin
Insurance No: AOK-9988776655
Group: Standard Vision Care
Policy Holder: T. Schmidt
Description of Ophthalmological Services RenderedThe following invoice details the professional medical services provided by our specialist Ophthalmologist practice located in the heart of Berlin, Germany. These services include comprehensive eye examinations, diagnostic imaging, and therapeutic interventions in accordance with the German Medical Services Catalogue (EBM) and applicable local regulations in Berlin.
| Code | Service Description | Qty | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|
| 01.001 | Comprehensive Ophthalmological Examination including anamnesis and visual acuity testing. | 1 | 85.00 | 85.00 |
| 02.015 | Slit-lamp biomicroscopy of the anterior segment of the eye (both eyes). | 1 | 45.00 | 45.00 |
| 03.022 | Dilated fundus examination to assess retina, optic nerve, and macula health. | 1 | 60.00 | 60.00 |
| 04.008 | Optical Coherence Tomography (OCT) of the macula and optic nerve head. | 1 | 120.00 | 120.00 |
| 05.011 | Corneal topography mapping for refractive error analysis and contact lens fitting. | 1 | 95.00 | 95.00 |
| 06.003 | Intraocular pressure measurement (Tonometry) to screen for glaucoma. | 1 | 30.00 | 30.00 |
| 07.005 | Prescription of corrective lenses and detailed consultation on vision correction options. | 1 | 40.00 | 40.00 |
| 08.010 | Follow-up consultation regarding post-examination findings and treatment plan in Berlin. | 1 | 55.00 | 55.00 |
Please remit payment within 30 days of the invoice date. Payments should be made via bank transfer to the following account:
Bank: Deutsche Bank AG Berlin
Account Holder: Dr. med. Elena Weber
IBAN: DE89 1007 0010 0123 4567 89
BIC: DEUTDEDBBER
Reference: INV-2023-10-045
This invoice is issued by a certified Ophthalmologist practice operating in Berlin, Germany. All services listed above were performed in accordance with the highest standards of ophthalmic care recognized in Germany. The fees charged reflect the specialized nature of eye care services provided by our medical team.
Tax Information: The value-added tax (VAT) of 19% has been applied as per the current German tax regulations for medical services not covered by statutory health insurance. If your insurance provider requires a separate VAT invoice, please contact our office.
Insurance Claims: For patients with private health insurance or supplementary vision coverage, this invoice can be submitted directly to your insurer for reimbursement. Please ensure that all details, including the patient's insurance number and the specific codes for each service, are clearly visible. Our practice is familiar with the requirements of major German insurance providers operating in Berlin.
Data Protection: In compliance with the General Data Protection Regulation (GDPR) and German data protection laws, your personal and medical information is handled with the utmost confidentiality. It is used solely for the purpose of providing medical services and processing this invoice.
Disputes: Should you have any questions or disputes regarding this invoice, please contact our billing department within 14 days of receipt. We are committed to resolving any issues promptly and professionally.
Thank you for choosing our Ophthalmologist practice in Berlin for your eye care needs. We are dedicated to providing you with the best possible vision care services.
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