Quotation Estimate Doctor General Practitioner in France Marseille –Free Word Template Download with AI
Doctor General Practitioner — France Marseille
Document Reference: QTE-MRS-2025-0047 | Issued: 15 June 2025
| Provider | Dr. Claire Fontaine, MD — Doctor General Practitioner, Cabinet Médical du Vieux-Port, 12 Rue de la République, 13001 Marseille, France |
| Registration No. | ARS PACA — RPPS 10101234567 | Ordre des Médecins des Bouches-du-Rhône |
| Client / Patient | Mr. Jean-Luc Moreau — 45 Avenue du Prado, 13006 Marseille, France |
| Insurance / Mutuelle | CPAM 13 (Caisse Primaire d'Assurance Maladie des Bouches-du-Rhône) + Complémentaire AXA France |
| Quotation Validity | 30 days from date of issue (expires 15 July 2025) |
| Currency | Euro (EUR) — all amounts inclusive of applicable French healthcare tariffs |
This Quotation Estimate is issued by the undersigned Doctor General Practitioner operating in France Marseille to provide a transparent, itemised breakdown of anticipated medical fees, diagnostic procedures, and follow-up consultations. The purpose of this document is to inform the patient and their insurance provider of the expected costs associated with the proposed course of care, in full compliance with the French public healthcare tariff system (Convention AMO) and the regulations governing private medical practice in the Bouches-du-Rhône department.
All fees listed herein reflect the standard rates applicable to a Doctor General Practitioner registered with the Ordre des Médecins and operating under the conventional framework in France Marseille. Where services exceed the standard AMO tariff, the differential (dépassement d'honoraires) is clearly indicated.
| Ref. | Service / Procedure | AMO Tariff (EUR) | Practitioner Fee (EUR) | Dépassement (EUR) | Estimated Reimbursement |
|---|---|---|---|---|---|
| 01 | Initial comprehensive consultation (Doctor General Practitioner, 30 min) | 25.00 | 35.00 | 10.00 | 80% CPAM + Mutuelle |
| 02 | Follow-up consultation (15 min, up to 3 sessions) | 25.00 | 30.00 | 5.00 | 80% CPAM + Mutuelle |
| 03 | Full blood panel (NFS, glycémie, bilan lipidique, TSH) | 42.00 | 42.00 | 0.00 | 65% CPAM + Mutuelle |
| 04 | 12-lead Electrocardiogram (ECG) — in-clinic | 18.00 | 22.00 | 4.00 | 70% CPAM + Mutuelle |
| 05 | Dermatological examination & dermoscopy (lesion assessment) | 25.00 | 40.00 | 15.00 | 70% CPAM + Mutuelle |
| 06 | Prescription of pharmacological treatment (3-month supply estimate) | 0.00 | 0.00 | 0.00 | 65%–100% CPAM + Mutuelle |
| 07 | Referral letter to specialist (Cardiologist, Marseille) & coordination | 0.00 | 15.00 | 15.00 | Not reimbursable |
| 08 | Home visit (within Marseille city limits, after-hours surcharge) | 30.00 | 50.00 | 20.00 | 80% CPAM + Mutuelle |
| 09 | Annual preventive health check-up (age 45–54 protocol) | 25.00 | 35.00 | 10.00 | 80% CPAM + Mutuelle |
| 10 | Telemedicine consultation (video, 15 min) — optional | 25.00 | 25.00 | 0.00 | 80% CPAM + Mutuelle |
| TOTAL ESTIMATED COST (EUR) | 215.00 | 314.00 | 79.00 | Varies per item | |
- Payment Method: The patient shall settle the full practitioner fee at the point of service using the Carte Vitale (CPAM), followed by direct billing of the complementary insurance (Mutuelle) via the Tiers Payant system where available. Cash, bank card, and cheque are accepted at the cabinet in France Marseille.
- Reimbursement Timeline: CPAM reimbursement is typically processed within 15 to 30 calendar days. Complementary Mutuelle reimbursement follows within 5 to 10 business days after CPAM settlement. The Doctor General Practitioner is not responsible for delays in third-party insurance processing.
- Dépassement d'honoraires: Any amount exceeding the AMO-conventioned tariff is the patient's direct responsibility unless covered by their complementary insurance. The patient acknowledges having been informed of these differentials prior to the consultation.
- Cancellation Policy: Appointments cancelled less than 24 hours in advance are subject to a 50% fee of the scheduled consultation rate. No-shows are charged the full consultation fee.
- Validity: This Quotation Estimate remains valid for 30 calendar days from the issue date. After expiry, fees may be subject to revision in accordance with updated national or regional healthcare regulations applicable in France Marseille.
- Regulatory Compliance: All services are delivered in accordance with the French Public Health Code (Code de la Santé Publique), the deontology code of the Ordre des Médecins, and the data protection regulations (RGPD / GDPR) governing patient medical records in France.
- Dispute Resolution: Any disagreement regarding the fees outlined in this Quotation Estimate shall first be addressed through direct communication with the Doctor General Practitioner's office. Unresolved disputes may be referred to the Conseil de l'Ordre des Médecins des Bouches-du-Rhône or the relevant CPAM mediation service in Marseille.
By signing below, the patient acknowledges receipt of this Quotation Estimate, confirms understanding of the itemised fees, and authorises the Doctor General Practitioner to proceed with the outlined course of care in France Marseille. The patient further confirms that they have been informed of their right to a second opinion and the availability of the free medical information line (39 19) for any questions regarding their rights within the French healthcare system.
For the Doctor General Practitioner:
Dr. Claire Fontaine, MD
Cabinet Médical du Vieux-Port
Marseille, France
Signature: ___________________________
Date: ___________________________
Patient / Authorized Representative:
Mr. Jean-Luc Moreau
Marseille, France
Signature: ___________________________
Date: ___________________________
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