Invoice Surgeon in Argentina Buenos Aires –Free Word Template Download with AI
Specialized Surgeon | Matriculation N° 45892
CABA Medical Association Member
Professional Medical Services
From (Provider)
Dr. Alejandro Rossi
Clinica Privada Buenos Aires
Av. Santa Fe 3250, Piso 4
C1425 CABA, Argentina Buenos Aires
CUIT: 20-12345678-9
Email: [email protected]
Bill To (Patient/Insurer)
María Elena Gonzalez
Insurer: OSDE Salud S.A.
Av. Corrientes 1234, Depto 5B
C1043 CABA, Argentina Buenos Aires
CUIT/CUIL: 27-98765432-1
Policy Number: OSDE-998877
Invoice Number: INV-2023-00458Date of Issue: October 24, 2023
Due Date: November 24, 2023 Date of Service: October 20, 2023
Procedure Date: October 20, 2023
Location: Hospital Italiano, Buenos Aires
| # | Description of Surgical Services | Code (CIP) | Unit Price (ARS) | Total (ARS) |
|---|---|---|---|---|
| 1 |
Pre-operative Surgical Consultation Comprehensive evaluation of the patient's medical history, physical examination, and surgical planning. This service includes the assessment of risks and benefits associated with the proposed procedure in accordance with the standards of the CABA Medical Association. |
20101 | 45,000.00 | 45,000.00 |
| 2 |
Primary Surgical Procedure: Laparoscopic Cholecystectomy Performance of minimally invasive surgery to remove the gallbladder. This fee covers the surgeon's technical skill, time in the operating room, and use of specialized surgical instruments. The procedure was conducted at a certified facility in Argentina Buenos Aires. |
45230 | 350,000.00 | 350,000.00 |
| 3 |
General Anesthesia Coordination Coordination with the anesthesiology team to ensure patient safety during the surgical intervention. Includes pre-anesthetic evaluation and intraoperative monitoring protocols specific to the surgeon's requirements. |
00112 | 80,000.00 | 80,000.00 |
| 4 |
Post-operative Immediate Care Monitoring of the patient in the recovery room immediately following the surgery. Includes assessment of vital signs, pain management initiation, and verification of surgical site stability. |
99211 | 30,000.00 | 30,000.00 |
| 5 |
Surgical Follow-up Consultation First post-operative visit to inspect incision sites, remove sutures if necessary, and evaluate healing progress. Includes prescription of necessary medications and dietary recommendations for recovery in Buenos Aires. |
20105 | 35,000.00 | 35,000.00 |
| 6 |
Medical Report and Documentation Preparation of detailed surgical reports for the patient's medical record and insurance provider. Includes operative notes, discharge summary, and certification of medical leave as required by Argentine labor laws. |
99000 | 15,000.00 | 15,000.00 |
Payment Terms and Conditions
This invoice represents the professional fees for surgical services rendered by Dr. Alejandro Rossi. Payment is due within 30 days of the invoice date. Payments can be made via bank transfer to Banco Galicia, CBU: 0070000000000000000000, or via approved credit card with applicable surcharges.
Please reference the Invoice Number (INV-2023-00458) on all payments. Late payments may incur interest charges in accordance with the regulations of the Central Bank of Argentina.
Important Information for Argentina Buenos Aires Residents
This document complies with the fiscal regulations of the Autonomous City of Buenos Aires (CABA). The surgeon is registered with the CABA Medical Association and holds a valid matriculation number. All procedures were performed adhering to the ethical and technical standards established by the Argentine Society of Surgeons.
For any questions regarding this invoice, please contact the billing department at the address listed above or via email. We appreciate your trust in our surgical care.
Legal Disclaimer: This invoice is a formal request for payment for medical services provided. The information contained herein is confidential and protected under Argentine data protection laws (Ley 25.326). The surgeon reserves the right to suspend services in case of non-payment. This document serves as proof of transaction for tax purposes and insurance claims. The prices listed are in Argentine Pesos (ARS) and are subject to change based on inflation indices and professional association guidelines.
By accepting these services, the patient acknowledges that surgery involves inherent risks. This invoice does not constitute a guarantee of specific medical outcomes but rather a record of the professional time, expertise, and resources dedicated to the patient's care in Buenos Aires, Argentina.
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