Invoice Radiologist in Mexico Mexico City –Free Word Template Download with AI

Bill To

Hospital General de Mexico
Department of Radiology
Dr. Balmis 148, Col. Doctores
Mexico City, CP 06726
Attn: Procurement Department

Description of Radiological Services

This document serves as a formal invoice for professional radiological services rendered by certified Radiologists at our facility located in Mexico City. The services detailed below were performed in accordance with the highest standards of medical imaging and diagnostic interpretation required by the Mexican health regulations.

Our team of Radiologists specializes in advanced diagnostic imaging, including but not limited to Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and specialized Ultrasound procedures. The following line items reflect the professional fees for the interpretation of diagnostic images and the technical execution of the procedures during the billing period.

Item	Description of Service	Quantity	Unit Price (MXN)	Total (MXN)
1	Professional Radiologist Fee - MRI Interpretation Detailed diagnostic interpretation of Magnetic Resonance Imaging of the Lumbar Spine. Includes analysis of soft tissue, vertebral alignment, and nerve root compression. Performed by a board-certified Radiologist in Mexico City.	1	$3,500.00	$3,500.00
2	Professional Radiologist Fee - CT Scan Interpretation Comprehensive analysis of Computed Tomography of the Chest with contrast. Evaluation of pulmonary structures and mediastinal lymph nodes. Report generated in Spanish and English.	1	$2,800.00	$2,800.00
3	Urgent Radiology Consultation Emergency interpretation of trauma series X-rays (Cervical Spine and Pelvis) for a patient admitted to the emergency room. Immediate verbal report provided to the attending physician followed by a written summary.	1	$4,200.00	$4,200.00
4	Advanced Ultrasound Guidance Real-time ultrasound guidance for a biopsy procedure performed by a Radiologist. Includes pre-procedure planning and post-procedure imaging assessment.	1	$5,500.00	$5,500.00
5	Second Opinion Radiology Review Review of external imaging studies (DICOM format) provided by another institution. Detailed comparative analysis provided by a senior Radiologist specializing in oncology.	1	$3,000.00	$3,000.00

Subtotal:	$19,000.00
VAT (IVA 16%):	$3,040.00
Total Due (MXN):	$22,040.00

Payment Instructions

Please remit payment via bank transfer to the following account within 30 days of the invoice date.

Bank: BBVA Bancomer
Account Name: Imagenes Diagnosticas CDMX S.A. de C.V.
CLABE: 012180001234567890
Reference: INV-2023-10-045

Terms and Conditions

1. Accuracy of Diagnosis: The services provided by the Radiologist are based on the best medical judgment at the time of interpretation. While we strive for absolute accuracy, medical imaging is subject to inherent limitations.

2. Regulatory Compliance: All procedures and billing practices comply with the regulations set forth by the Mexican Ministry of Health (Secretaría de Salud) and the local health authority of Mexico City.

3. Data Privacy: Patient data and medical records are handled in strict accordance with the Federal Law on Protection of Personal Data Held by Private Parties (LFPDPPP).

4. Late Payments: Invoices not paid by the due date may be subject to a late fee of 2% per month on the outstanding balance.

5. Disputes: Any discrepancies regarding this invoice must be reported within 15 days of receipt. Please contact our billing department at [email protected].

Thank you for your business. We are committed to providing the highest quality radiological services in Mexico City.

This invoice is a legal document issued by Imagenes Diagnosticas CDMX S.A. de C.V., a company registered in Mexico City. The services described herein were performed by licensed medical professionals holding valid credentials from the Mexican Medical Council. This document is valid for tax deduction purposes in Mexico.

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