Invoice Surgeon in Australia Melbourne –Free Word Template Download with AI
Level 12, Collins Medical Centre
300 Collins Street
Melbourne VIC 3000
Australia
Phone: +61 3 9000 1234
Email: [email protected]
MB Number: 1234567890
ABN: 12 345 678 901
PRBA Member: Yes
INVOICE
Invoice Number: INV-2023-10-459
Date of Issue: 24 October 2023
Date of Service: 15 October 2023
Due Date: 24 November 2023
Bill To:
Mr. James Wilson
45 Chapel Street, South Yarra
Melbourne VIC 3141
Australia
Health Fund: Bupa Private Health Insurance
Member Number: BUP-99887766
Group Number: GRP-554433
| Item | MBS Item No. | Description of Surgical Services | Fee (AUD) | MBS Schedule Fee |
|---|---|---|---|---|
| 1 | 45102 | Arthroscopy, Knee: Diagnostic arthroscopy of the knee joint performed by Consultant Surgeon Dr. A. Sterling at the Melbourne Private Hospital. Procedure included detailed visual inspection of the menisci and articular cartilage to assess structural integrity and identify sources of chronic pain. | $850.00 | $420.50 |
| 2 | 45104 | Arthroscopic Meniscectomy: Partial meniscectomy of the medial meniscus. This surgical intervention was conducted to remove the torn fragment of the meniscus causing mechanical locking and inflammation. The procedure was performed under general anaesthesia with standard sterile protocols. | $1,200.00 | $650.00 |
| 3 | 45106 | Arthroscopic Chondroplasty: Debridement and chondroplasty of the medial femoral condyle. The surgeon performed smoothing of the articular cartilage surface to reduce friction and prevent further degeneration of the joint tissue during the same operative session. | $650.00 | $380.00 |
| 4 | 23 | Post-Operative Consultation: Follow-up appointment conducted on 22 October 2023 at the Collins Street Clinic in Melbourne. The surgeon reviewed the surgical site, assessed wound healing, removed sutures, and provided detailed instructions regarding post-operative rehabilitation and physiotherapy requirements. | $220.00 | $85.00 |
Payment Instructions & Important Information:
Private Health Insurance: Please present this invoice to your health fund for claim processing. As a member of the Private Health Insurance Rebate scheme, you may be eligible for a rebate on the MBS Schedule Fee portion of these charges. The "Gap" amount (the difference between the Surgeon's fee and the MBS Schedule Fee) is the patient's responsibility unless covered by your specific fund agreement.
Bank Transfer Details:
Bank: Commonwealth Bank of Australia
Account Name: Sterling Surgical Practice
BSB: 062-000
Account Number: 12345678
Reference: INV-2023-10-459
Terms: Payment is due within 30 days of the invoice date. Please contact our billing department in Melbourne if you have any queries regarding this invoice or your health fund rebate.
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