Invoice Radiologist in Australia Sydney –Free Word Template Download with AI
Level 12, 100 George Street
Sydney NSW 2000, Australia
ABN: 12 345 678 901
Phone: +61 2 9123 4567
Email: [email protected]
Invoice Number: INV-2023-8942
Date Issued: 24 October 2023
Due Date: 24 November 2023
Reference: Patient ID #88421 / Ref: Dr. A. Smith
Bill To:
Medicare Australia / Private Health Fund
Attn: Claims Processing Department
P.O. Box 5200
Sydney NSW 2001, Australia
Patient Name: John Michael Doe
Date of Birth: 15/05/1978
Service Date: 20 October 2023
| Item | Description of Radiological Services | MBS Item No. | Quantity | Unit Price (AUD) | Total (AUD) |
|---|---|---|---|---|---|
| 1 |
Magnetic Resonance Imaging (MRI) - Brain Comprehensive MRI scan of the brain without contrast. Performed by a specialist Radiologist in Sydney. Includes detailed interpretation of neuroanatomical structures, assessment for ischemic changes, mass lesions, or demyelinating disease. Report generated in accordance with Australian Medical Board standards. |
45566 | 1 | $450.00 | $450.00 |
| 2 |
Computed Tomography (CT) - Chest High-resolution CT scan of the thorax. Conducted at our Sydney facility using state-of-the-art 64-slice technology. Evaluation of pulmonary parenchyma, mediastinum, and pleural spaces. Includes specialist Radiologist reporting and comparison with prior imaging if available. |
45530 | 1 | $380.00 | $380.00 |
| 3 |
Ultrasound - Abdomen (Complete) Diagnostic ultrasound examination of the liver, gallbladder, pancreas, spleen, kidneys, and aorta. Performed by a qualified sonographer and interpreted by a consultant Radiologist. Essential for assessing abdominal pain or organ pathology within the Sydney healthcare network. |
45510 | 1 | $290.00 | $290.00 |
| 4 |
Specialist Radiologist Consultation & Reporting Professional fee for the interpretation of all imaging studies listed above. Includes a comprehensive written report delivered to the referring physician within 24 hours. This service ensures accurate diagnosis and management planning for the patient in Australia. |
N/A | 1 | $250.00 | $250.00 |
| 5 |
Contrast Media Administration Intravenous contrast agent used during the CT Chest procedure to enhance vascular and tissue visualization. Includes pre-screening for allergies and renal function assessment as per Australian safety guidelines. |
45532 | 1 | $120.00 | $120.00 |
Terms and Conditions & Payment Instructions
This Invoice represents the professional fees for radiological services provided by Harbour City Radiology Specialists in Sydney, Australia. All prices are quoted in Australian Dollars (AUD) and include the applicable 10% Goods and Services Tax (GST) as required by the Australian Taxation Office (ATO).
Payment Methods: Payment is due within 30 days of the invoice date. We accept Bank Transfer (BSB: 062-000, Account: 12345678), Credit Card (Visa/Mastercard), and direct Medicare bulk billing where applicable. Please quote the Invoice Number (INV-2023-8942) as the payment reference.
Radiologist Reporting: All diagnostic reports are generated by fellowship-trained Radiologists registered with the Medical Board of Australia. These reports are confidential and will be sent directly to your referring physician. If you require a copy of your report, please contact our Sydney office.
Privacy: Your personal health information is handled in strict accordance with the Privacy Act 1988 (Cth) and the Australian Privacy Principles. We ensure the highest level of data security for all patient records stored in our Sydney facility.
Disputes: If you have any questions regarding this Invoice or the services provided, please contact our billing department at +61 2 9123 4567 or email [email protected]. We are committed to resolving any discrepancies promptly.
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