Invoice Surgeon in China Beijing –Free Word Template Download with AI
Department of Advanced Surgical Sciences
No. 88, Chaoyang North Road, Chaoyang District
Beijing, 100020, People's Republic of China
Tax ID: 91110105MA01XXXXXK
Phone: +86 10 8588 9900 | Email: [email protected]
Invoice Number: INV-BJ-2023-8842
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Currency: CNY (Chinese Yuan)
Bill To:Patient Name: Mr. Alexander J. Smith
Insurance Provider: Global Health International
Policy Number: GHI-99887766
Address: 123 International Business Park, Haidian District, Beijing, China
Description of Surgical ServicesThis invoice details the professional fees and associated costs for surgical procedures performed at the Beijing Capital Medical Center. The services were rendered by a board-certified Surgeon specializing in orthopedic and reconstructive surgery. The procedure took place within the state-of-the-art surgical wing located in the Chaoyang District of Beijing, China, adhering to the highest international standards of medical care and hygiene protocols mandated by the National Health Commission of China.
| Item | Description of Service | Date | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|
| 1 | Lead Surgeon Professional Fee: Comprehensive fee for the primary Surgeon for the total knee arthroplasty procedure. Includes pre-operative assessment, surgical execution, and immediate post-operative evaluation. | Oct 20, 2023 | 45,000.00 | 45,000.00 |
| 2 | Assistant Surgeon Fee: Professional services provided by the assisting Surgeon during the operation to ensure optimal surgical outcomes and patient safety. | Oct 20, 2023 | 12,000.00 | 12,000.00 |
| 3 | Surgical Facility Fee: Usage of Operating Room A4 in Beijing. Includes sterilization, anesthesia equipment, and nursing staff support during the procedure. | Oct 20, 2023 | 28,500.00 | 28,500.00 |
| 4 | Implants and Prosthetics: High-grade titanium knee joint replacement components sourced from certified international suppliers approved for use in China. | Oct 20, 2023 | 35,000.00 | 35,000.00 |
| 5 | Post-Operative Care: Monitoring and medical management by the Surgeon and medical team for 3 days following the surgery in the Intensive Recovery Unit. | Oct 21-23, 2023 | 15,000.00 | 15,000.00 |
| 6 | Diagnostic Imaging: Pre-operative MRI and X-rays conducted at the Beijing Capital Medical Center radiology department. | Oct 18, 2023 | 4,500.00 | 4,500.00 |
Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer to the following account located in Beijing, China:
- Bank Name: Bank of China, Beijing Chaoyang Branch
- Account Name: Beijing Capital Medical Center Co., Ltd.
- Account Number: 6222 0210 0123 4567 890
- SWIFT Code: BKCHCNBJ
- Reference: INV-BJ-2023-8842
1. This invoice is issued in accordance with the financial regulations of the People's Republic of China.
2. The Surgeon and medical team at Beijing Capital Medical Center have provided services based on the best medical judgment available.
3. Late payments may incur a penalty fee of 1.5% per month on the outstanding balance.
4. Please retain this document for your medical records and insurance reimbursement purposes.
5. For any discrepancies regarding the Surgeon's fees or hospital charges, please contact our billing department in Beijing within 14 days.
Authorized Signature
Dr. Li Wei, Chief of Surgery
Beijing Capital Medical Center
Received By
__________________________
Date: ____________________
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