Invoice Surgeon in France Paris –Free Word Template Download with AI
Specialist Surgeon (Chirurgien Généraliste)
12 Avenue de la République
75011 Paris, France
Tel: +33 1 42 77 88 99
Email: [email protected]
SIRET: 823 456 789 00012 | TVA Intracommunautaire: FR 12 823456789
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Date of Service: October 20, 2023
Due Date: November 24, 2023
Bill To (Payer)
Global Health Insurance Ltd.
Claims Department
45 Rue de Rivoli
75004 Paris, France
Policy Number: GH-99887766
Patient Details
Name: Jean-Pierre Martin
Date of Birth: 15/05/1978
SSN (Numéro de Sécurité Sociale): 1 78 05 75 123 456 78
Address: 8 Rue de la Paix, 75002 Paris
Medical Context and Service Description
This invoice represents the professional fees for surgical services rendered by Dr. Alexandre Dubois, a certified surgeon practicing in Paris, France. The patient presented with acute appendicitis requiring immediate surgical intervention. The procedure was performed at the Clinique de la Tour Eiffel, a recognized medical facility in Paris.
The surgical procedure involved a laparoscopic appendectomy. This minimally invasive technique is standard practice in modern French healthcare for this condition, offering reduced recovery time and lower risk of infection compared to open surgery. The surgeon performed a thorough pre-operative assessment, administered local anesthesia assistance, executed the surgical removal of the appendix, and provided immediate post-operative care instructions.
In accordance with the French National Health Insurance (Assurance Maladie) regulations and the standard fee schedule (Nomenclature des Actes Professionnels), the following items are billed. Please note that this invoice is issued in Euros (EUR) as per the currency standards of France. The breakdown includes the surgical act itself, the pre-operative consultation, and the post-operative follow-up visit conducted in our Paris office.
| Code | Description of Service | Qty | Unit Price (€) | Total (€) |
|---|---|---|---|---|
| 01.01.001 | Pre-operative Surgical Consultation and Assessment in Paris Clinic | 1 | 85.00 | 85.00 |
| 02.04.015 | Laparoscopic Appendectomy (Surgical Procedure) | 1 | 1,250.00 | 1,250.00 |
| 02.04.020 | Surgical Assistant Fees (Co-Surgeon) | 1 | 350.00 | 350.00 |
| 03.01.005 | Post-operative Wound Care and Suture Removal | 1 | 65.00 | 65.00 |
| 04.00.001 | Medical Certificate and Hospitalization Report for Insurance | 1 | 45.00 | 45.00 |
Payment Instructions
Payment is due within 30 days of the invoice date. Please make checks payable to "Dr. Alexandre Dubois" or use the bank transfer details below.
Bank Name: Crédit Agricole Paris
IBAN: FR76 3000 6000 0112 3456 7890 189
BIC: AGRIFRPP
Reference: INV-2023-10-045
For any questions regarding this invoice or the surgical procedure, please contact our office in Paris during business hours (Monday to Friday, 9:00 AM - 6:00 PM).
Authorized Signature
Dr. Alexandre DuboisSurgeon ⬇️ Download as DOCX Edit online as DOCX
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