Quotation Estimate Doctor General Practitioner in Colombia Medellín –Free Word Template Download with AI
Professional Medical Services – Doctor General Practitioner
Medellín, Antioquia – Colombia
Official Quotation Estimate Document
1. Provider InformationMedical Practice
Clinica Integral del Valle
Doctor General Practitioner Services
Calle 43 #49A-120, El Poblado
Medellín, Antioquia – Colombia
NIT: 900.456.789-1
RIPS Registration: 123456789
Phone: +57 (604) 444 5566
Email: [email protected]
Attending Physician
Dr. Alejandro Restrepo Gómez
Doctor General Practitioner
Professional License (Régimen): 2015-08-4432
Specialty: General Medicine / Family Medicine
Affiliated Institutions: Hospital San Rafael, Clínica Las Américas
Languages: Spanish, English
Available: Monday to Saturday, 7:00 AM – 6:00 PM
Client Details
Company / Individual: [Client Name to be completed]
Identification (C.C. / NIT): [To be provided]
Address: [Client Address, Medellín or surrounding area – Colombia]
Contact Person: [Name]
Phone: [Phone Number]
Email: [Email Address]
Health Insurance (EPS / Aseguradora): [Plan Name and Policy Number]
This Quotation Estimate outlines the comprehensive medical services to be rendered by a qualified Doctor General Practitioner at our facility in Colombia Medellín. The Doctor General Practitioner will provide primary care, preventive medicine, diagnosis, and initial treatment for a wide range of non-emergency medical conditions. All services comply with the Colombian health regulatory framework established by the Ministry of Health and Social Welfare (Ministerio de Salud y Protección Social) and the applicable RIPS (Régimen de Prestación de Servicios) regulations in force in the city of Medellín.
| # | Service Description | Frequency / Duration | Unit (COP) | Total (COP) |
|---|---|---|---|---|
| 1 | Initial Consultation with Doctor General Practitioner – Comprehensive medical history, physical examination, and preliminary diagnosis | 1 session / 45 min | $185,000 | $185,000 |
| 2 | Follow-up Consultation with Doctor General Practitioner – Treatment plan review, medication adjustment, and progress assessment | 4 sessions / 30 min each | $120,000 | $480,000 |
| 3 | Preventive Health Screening Package – Blood work (CBC, lipid panel, glucose, liver and kidney function), urinalysis, and ECG performed under Doctor General Practitioner supervision | 1 package | $320,000 | $320,000 |
| 4 | Vaccination Administration and Immunization Record Update – Doctor General Practitioner administered vaccines per Colombian national immunization schedule | 1 session | $95,000 | $95,000 |
| 5 | Chronic Disease Management Plan – Ongoing Doctor General Practitioner oversight for hypertension, diabetes, or dyslipidemia including quarterly check-ins and lab monitoring | Quarterly / 12 months | $150,000 | $600,000 |
| 6 | Medical Certificate and Referral Documentation – Issuance of official medical certificates, work incapacity notes, and specialist referrals by the Doctor General Practitioner | As needed (up to 5) | $45,000 | $225,000 |
| 7 | Telemedicine Consultation with Doctor General Practitioner – Remote follow-up via secure video platform for minor adjustments and general inquiries | 2 sessions / 20 min each | $85,000 | $170,000 |
| 8 | Home Visit by Doctor General Practitioner – In-home medical assessment for elderly or mobility-limited patients within the Medellín metropolitan area | 1 visit / 60 min | $250,000 | $250,000 |
| TOTAL ESTIMATED COST (COP): | $2,325,000 | |||
| TOTAL ESTIMATED COST (USD – approx. at 3,950 COP/USD): | $588.61 | |||
- Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After this period, prices may be adjusted in accordance with the Colombian Consumer Protection Law (Ley 1480 de 2011) and current market conditions in Colombia Medellín.
- Payment Terms: Payment is due within fifteen (15) business days from the date of acceptance of this Quotation Estimate. Accepted methods include bank transfer (Bancolombia, Davivienda, BBVA Colombia), credit/debit card, or cash at our Medellín office. A 10% discount applies for full prepayment.
- Insurance Coordination: If the client holds active health insurance (EPS) coverage under the Colombian General Regime (Régimen Contributivo) or Subsidized Regime (Régimen Subsidiado), the Doctor General Practitioner services may be partially or fully covered. The client is responsible for any co-payments or services outside the EPS catalog.
- Schedule and Cancellation: Appointments with the Doctor General Practitioner must be scheduled at least 48 hours in advance. Cancellations made less than 24 hours before the appointment will incur a 50% fee of the session cost.
- Scope Limitation: This Quotation Estimate covers primary care services rendered by the Doctor General Practitioner. Emergency services, surgical procedures, hospitalization, and specialized consultations (cardiology, neurology, etc.) are not included and will be quoted separately.
- Confidentiality: All medical information is handled in strict accordance with Colombian Law 1581 of 2012 (Data Protection Law) and the patient's right to medical confidentiality as established in the Colombian Constitution (Article 15) and Law 100 of 1993.
- Regulatory Compliance: All services are delivered in compliance with the resolutions issued by the Ministry of Health and Social Welfare of Colombia, the Superintendencia Nacional de Salud, and the applicable regulations of the city of Medellín, Antioquia.
- Dispute Resolution: Any disputes arising from this Quotation Estimate shall be resolved through the competent courts of Medellín, Antioquia, Colombia, or through the Superintendencia Nacional de Salud as the regulatory authority for health services in Colombia.
By signing below, the client acknowledges receipt and acceptance of this Quotation Estimate for Doctor General Practitioner services to be provided in Colombia Medellín. The client confirms that all information provided is accurate and agrees to the terms and conditions outlined above.
Provider RepresentativeDr. Alejandro Restrepo Gómez
Doctor General Practitioner
Clinica Integral del Valle – Medellín, Colombia
Date: _______________ Client / Authorized Representative
Name: _____________________________
ID / NIT: _____________________________
Signature: _____________________________
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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