Invoice Surgeon in Zimbabwe Harare –Free Word Template Download with AI
Lead Surgeon: Dr. T. Moyo, MBChB, FCPS (Surgery)
123 Samora Machel Avenue, Borrowdale
Harare, Zimbabwe
Tel: +263 242 700 000 | Email: [email protected]
Reg No: ZIM-MED-998877
Invoice Number: INV-ZW-2023-0892
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Reference: SURG-OP-445
Bill To:
Patient Name: Mr. James Chikumbutso
Insurance Provider: National Health Insurance (NHI)
Policy Number: NHI-ZW-554433
Address: 45 Robert Mugabe Road, Avondale
Harare, Zimbabwe
Service Location:
Hospital: Parirenyatwa Group of Hospitals
Department: General Surgery Unit
Room: Operating Theatre 4
Harare, Zimbabwe
| # | Description of Surgical Services | Date | Unit Price (USD) | Total (USD) |
|---|---|---|---|---|
| 1 |
Pre-Operative Consultation & Assessment Comprehensive evaluation by the Surgeon in Harare to determine surgical necessity, review medical history, and outline risks. Includes physical examination and diagnostic review. |
Oct 10, 2023 | 150.00 | 150.00 |
| 2 |
Diagnostic Imaging Review Surgeon's professional fee for interpreting CT scans and MRI results specific to the abdominal region to plan the surgical approach. |
Oct 12, 2023 | 75.00 | 75.00 |
| 3 |
Primary Surgical Procedure: Laparoscopic Cholecystectomy Fee for the Surgeon's professional services during the removal of the gallbladder. Performed at Parirenyatwa Hospital, Harare. Includes anesthesia coordination and surgical team leadership. |
Oct 15, 2023 | 2,500.00 | 2,500.00 |
| 4 |
Operative Time Extension Additional fee for surgical time exceeding the standard 2-hour block due to complex adhesions found during the procedure in Harare. |
Oct 15, 2023 | 300.00 | 300.00 |
| 5 |
Post-Operative Care & Wound Management Surgeon's follow-up visits on Oct 18 and Oct 22. Includes dressing changes, suture removal, and assessment of recovery progress at the Harare clinic. |
Oct 22, 2023 | 200.00 | 200.00 |
| 6 |
Medical Certification & Documentation Preparation of official surgical reports, discharge summaries, and sick leave certificates required for Zimbabwean labor laws and insurance claims. |
Oct 24, 2023 | 50.00 | 50.00 |
| Subtotal: | $3,275.00 |
| Discount (Insurance Agreement): | -$327.50 |
| Net Total: | $2,947.50 |
| TOTAL DUE (USD): | $2,947.50 |
Payment Instructions & Terms
Currency: All amounts are quoted in United States Dollars (USD). Payment in Zimbabwe Gold (ZiG) is accepted at the prevailing Reserve Bank of Zimbabwe rate on the day of payment.
Bank Transfer Details:
Bank: CBZ Bank Zimbabwe
Branch: Borrowdale, Harare
Account Name: Harare Surgical Specialists (Pvt) Ltd
Account Number: 100-22334455
Branch Code: 100-001
Reference: INV-ZW-2023-0892
Terms: Payment is due within 30 days of the invoice date. Late payments may incur a penalty interest rate of 2% per month. Please ensure the invoice number is included in all payment references to facilitate reconciliation.
Important Notes Regarding Surgeon Services
This invoice represents the professional fees charged by the Surgeon for the medical services rendered. It does not include hospital facility fees, anesthesia fees, or pharmaceutical costs, which are billed separately by Parirenyatwa Group of Hospitals.
The Surgeon has performed all duties in accordance with the standards set by the Medical and Dental Council of Zimbabwe. The patient has been informed of all risks and benefits associated with the procedure performed in Harare.
For any queries regarding this invoice, please contact our billing department in Harare during business hours (Monday to Friday, 08:00 - 16:00).
Authorized By:
Dr. T. Moyo
Lead Surgeon
Received By:
__________________________
Date: ____________________
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT