Invoice Radiologist in Ghana Accra –Free Word Template Download with AI
Lead Radiologist: Dr. Kwame Mensah, FRCR
15 Independence Avenue, Ridge
Accra, Greater Accra Region, Ghana
Tel: +233 30 277 1234 | Email: [email protected]
TIN: GH-9876543210
Invoice #: INV-2023-10-089
Date: October 24, 2023
Due Date: November 07, 2023
Status: Pending Payment
Bill To:
Client: Ghana Health Service / Private Patient
Attn: Accounts Payable Department
Ministry of Health Complex
Accra, Ghana
Payment Details:
Bank: Ecobank Ghana Limited
Branch: Accra Main Branch
Account Name: Accra Advanced Imaging Ltd.
Account Number: 1002345678901
Currency: Ghana Cedi (GHS)
| # | Description of Radiological Services | Quantity | Unit Price (GHS) | Total (GHS) |
|---|---|---|---|---|
| 1 |
Computed Tomography (CT) Scan - Abdomen & Pelvis Performed by Senior Radiologist. Includes contrast media administration and detailed diagnostic report. |
1 | 850.00 | 850.00 |
| 2 |
Magnetic Resonance Imaging (MRI) - Brain High-resolution neuro-imaging. Includes interpretation by specialist neuroradiologist. |
1 | 1,200.00 | 1,200.00 |
| 3 |
Digital X-Ray - Chest (PA & Lateral) Standard thoracic imaging for respiratory assessment. |
2 | 150.00 | 300.00 |
| 4 |
Ultrasound - Abdominal (Full) Real-time sonography of liver, gallbladder, kidneys, and pancreas. |
1 | 450.00 | 450.00 |
| 5 |
Radiologist Consultation & Report Writing Comprehensive clinical correlation and written diagnostic report for all above procedures. |
1 | 300.00 | 300.00 |
| 6 |
Emergency After-Hours Radiology Service Urgent interpretation fee for scans performed outside standard business hours in Accra. |
1 | 250.00 | 250.00 |
Terms and Conditions:
- Payment Terms: Payment is due within 14 days of the invoice date. Late payments may incur a penalty fee of 2% per month.
- Currency: All amounts are quoted in Ghana Cedis (GHS). Foreign currency payments will be converted at the prevailing bank rate on the date of receipt.
- Validity: This invoice is valid for 30 days. Please reference Invoice #INV-2023-10-089 in all communications and payments.
- Medical Records: Digital copies of radiological images (DICOM format) and reports are available upon request for a nominal data retrieval fee.
- Disputes: Any discrepancies regarding the services provided by our Radiologist must be reported within 7 days of receipt of this invoice.
- Location: Services rendered at our facility in Accra, Ghana. Traveling radiology services are billed separately.
Authorized By (Radiologist):
Dr. Kwame Mensah
Lead Radiologist
Received By (Client):
__________________________
Date: ____________________
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