Invoice Radiologist in Tanzania Dar es Salaam –Free Word Template Download with AI
Lead Radiologist: Dr. Amina Juma, MBChB, FCPS (Radiology)
Plot 45, Sam Nujoma Road, Masaki
Dar es Salaam, Tanzania
Tel: +255 22 260 1234 | Email: [email protected]
TIN: 123-456-789-00-000
Invoice Number: INV-2023-DS-0892
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Service Period: October 20, 2023
Bill To:Client Name: Muhimbili National Hospital / Private Patient Account
Department: Oncology Ward B
Address: United Nations Road, Upanga
City: Dar es Salaam, Tanzania
Reference/Patient ID: P-998877-AA
Description of Radiological Services RenderedThe following Invoice details the professional fees charged by the Lead Radiologist for diagnostic imaging interpretation, consultation, and reporting services provided at our facility in Dar es Salaam, Tanzania. These services adhere to the highest standards of medical imaging protocols recognized by the Tanzania Medical and Dental Council.
| # | Service Description / Radiological Procedure | Qty | Unit Price (TZS) | Total (TZS) |
|---|---|---|---|---|
| 1 |
Computed Tomography (CT) Scan - Chest & Abdomen Comprehensive radiological interpretation of contrast-enhanced CT scans. Includes detailed analysis of thoracic and abdominal structures, identification of pathologies, and generation of a formal diagnostic report for the referring physician. |
1 | 450,000 | 450,000 |
| 2 |
Magnetic Resonance Imaging (MRI) - Brain Specialized radiologist review of high-resolution MRI sequences. Evaluation of neurological structures, vascular integrity, and soft tissue anomalies. Includes urgent consultation notes due to critical findings. |
1 | 600,000 | 600,000 |
| 3 |
Ultrasound Guided Biopsy Procedure Real-time radiological guidance for tissue sampling. Includes pre-procedure planning, sterile field setup, image acquisition during needle insertion, and post-procedure imaging to confirm hemostasis. |
1 | 350,000 | 350,000 |
| 4 |
Emergency Radiology Consultation After-hours availability fee for the Radiologist to provide immediate interpretation of trauma X-rays and CT scans at the Dar es Salaam facility. |
2 | 150,000 | 300,000 |
| 5 |
Digital Image Archiving & PACS Access Secure storage and transmission of DICOM images via the Picture Archiving and Communication System (PACS) for external review by specialists in Tanzania. |
1 | 50,000 | 50,000 |
| Subtotal: | 1,750,000 TZS |
| VAT (18%): | 315,000 TZS |
| TOTAL DUE: | 2,065,000 TZS |
Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer to the following account details located in Dar es Salaam:
- Bank Name: CRDB Bank Tanzania
- Branch: Masaki Branch
- Account Name: Dar es Salaam Advanced Imaging Center Ltd.
- Account Number: 0123456789012
- SWIFT Code: CRDBTZDX
1. Professional Liability: This Invoice covers the professional fees of the Radiologist for the interpretation of medical images. The diagnostic reports provided are based on the images available at the time of review. While every effort is made to ensure accuracy, the Radiologist assumes no liability for clinical decisions made solely based on this report without further clinical correlation.
2. Regulatory Compliance: All radiological procedures and billing practices outlined in this document comply with the regulations set forth by the Tanzania Medical and Dental Council (TMDC) and the Tanzania Revenue Authority (TRA). The VAT charged is in accordance with current Tanzanian tax laws.
3. Data Privacy: In accordance with the Data Protection Act of Tanzania, all patient data and medical images associated with this Invoice are handled with strict confidentiality. Access to these records is restricted to authorized medical personnel within Dar es Salaam Advanced Imaging Center.
4. Disputes: Any discrepancies regarding the services rendered or the amounts charged must be reported within 14 days of receiving this Invoice. Please contact our billing department in Dar es Salaam for resolution.
5. Late Payments: Invoices not paid by the due date may be subject to a late fee of 2% per month on the outstanding balance.
Thank you for trusting our Radiologist and our team with your healthcare needs in Tanzania. We are committed to providing world-class diagnostic imaging services in Dar es Salaam.
Authorized SignatureDr. Amina Juma
Lead Radiologist Received By
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