Invoice Psychiatrist in Australia Sydney –Free Word Template Download with AI
MBBS, FRANZCP
Private Practice
Level 4, 123 Medical Centre Drive
North Sydney, NSW 2060
Australia Sydney
Phone: +61 2 9999 8888
Email: [email protected]
INVOICE
BILL TO:
Mr. James Anderson
45 Harbour View Street
Bondi Beach, NSW 2026
Australia Sydney
Medicare Number: 1234 567890 12345
Private Health Fund: Bupa (Policy #BP-998877)
This invoice relates to psychiatric services provided under the Australian Medicare Benefits Schedule (MBS). Please note that the amounts listed below represent the total professional fees charged by the Psychiatrist. If you hold a valid Mental Health Treatment Plan from your General Practitioner (GP), you may be eligible for a Medicare rebate. The gap amount (the difference between the fee and the rebate) is the patient's responsibility unless bulk billing is applied.
| Description of Services | MBS Item Number | Date of Service | Fee (AUD) |
|---|---|---|---|
|
Initial Psychiatric Assessment Comprehensive evaluation including clinical history, mental state examination, and formulation of diagnosis. This consultation was conducted at the North Sydney clinic. |
2715 | 20 Oct 2023 | $350.00 |
|
Psychiatric Consultation (Follow-up) Review of medication efficacy, monitoring of side effects, and adjustment of treatment plan for anxiety management. |
2714 | 24 Oct 2023 | $280.00 |
|
Psychiatric Report for Private Health Fund Preparation of detailed clinical report regarding ongoing treatment requirements and prognosis. |
N/A | 24 Oct 2023 | $150.00 |
Payment Instructions & Terms:
Payment is due within 14 days of the invoice date. Please make payments via direct bank transfer or credit card.
Bank Transfer Details:
Bank: Commonwealth Bank of Australia
Account Name: Vance Psychiatry Pty Ltd
BSB: 062-000
Account Number: 12345678
Reference: INV-2023-10-045
Credit Card:
Please contact the clinic administration to arrange payment by phone. We accept Visa, Mastercard, and Amex.
Important Notice:
This invoice is issued in accordance with Australian tax laws. The ABN provided is valid and registered with the Australian Business Register. If you have not received this invoice by the due date, please contact our office immediately. Late payments may incur a 1.5% monthly interest charge.
Confidentiality:
All patient information contained within this invoice and related medical records is strictly confidential and protected under the Privacy Act 1988 (Cth) and the Australian Privacy Principles.
Thank you for choosing our psychiatric services in Australia Sydney. We are committed to providing high-quality mental health care.
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