Quotation Estimate Surgeon in Argentina Córdoba –Free Word Template Download with AI
Professional Surgical Services — Argentina Córdoba
Clinica Médica del Centro — Av. Vélez Sarsfield 1250, Córdoba, Argentina
Tel: +54 351 420-0000 | Email: [email protected]
1. Purpose of This Quotation EstimateThis Quotation Estimate has been prepared specifically for Mr. Ricardo A. Fernández to provide a comprehensive and transparent breakdown of all costs associated with the surgical intervention to be performed by a certified Surgeon at our facility located in Argentina Córdoba. This document serves as a formal, non-binding estimate of the professional, technical, and ancillary services required for the planned procedure. All figures are expressed in Argentine Pesos (ARS) and reflect current market rates as of the date of issue. The Quotation Estimate is valid for thirty (30) calendar days from the date of issue, after which a revised estimate may be required to account for any changes in pricing, availability, or regulatory conditions within the province of Córdoba.
2. Surgeon and Professional CredentialsThe Surgeon assigned to this case is Dr. María Elena Sánchez, a board-certified General and Vascular Surgeon with over twenty-two years of clinical experience. Dr. Sánchez is registered with the Colegio Médico de la Provincia de Córdoba (License No. 45.678) and holds additional certifications in minimally invasive surgical techniques. The Surgeon will be supported by a dedicated anesthesiology team, a surgical nursing staff, and a post-operative recovery team, all operating within the accredited surgical wing of our clinic in Argentina Córdoba. The selection of this particular Surgeon was made in consultation with the patient's primary care physician and is based on the specific nature of the procedure, the Surgeon's demonstrated expertise, and the patient's medical history.
3. Itemized Cost Breakdown| # | Description of Service | Quantity | Unit Price (ARS) | Subtotal (ARS) |
|---|---|---|---|---|
| 1 | Pre-operative consultation and evaluation by the Surgeon (includes physical examination, review of medical records, and discussion of surgical plan) | 1 session | 45,000.00 | 45,000.00 |
| 2 | Pre-operative laboratory work and diagnostic imaging (complete blood count, coagulation panel, chest X-ray, abdominal ultrasound, ECG) | 1 package | 38,500.00 | 38,500.00 |
| 3 | Surgical procedure performed by the Surgeon (laparoscopic cholecystectomy, including operative time, surgical instruments, and disposable materials) | 1 procedure | 385,000.00 | 385,000.00 |
| 4 | Anesthesiology services (general anesthesia, intra-operative monitoring, and anesthesiologist fees) | 1 session | 95,000.00 | 95,000.00 |
| 5 | Operating room facility fee (surgical suite, sterilization, nursing staff, and equipment usage in Argentina Córdoba) | 1 session | 72,000.00 | 72,000.00 |
| 6 | Post-operative hospitalization and recovery (24-hour observation in a private recovery room, including nursing care and monitoring) | 1 night | 55,000.00 | 55,000.00 |
| 7 | Post-operative follow-up consultation with the Surgeon (wound inspection, suture removal, and discharge clearance at 10 days post-surgery) | 1 session | 30,000.00 | 30,000.00 |
| 8 | Pharmaceuticals and consumables (intravenous fluids, analgesics, antibiotics, wound dressings, and compression garments) | 1 package | 28,000.00 | 28,000.00 |
| 9 | Administrative and documentation fees (surgical report, medical records, and insurance billing coordination for Argentina Córdoba providers) | 1 package | 12,500.00 | 12,500.00 |
| TOTAL ESTIMATED COST (ARS) | 761,000.00 | |||
- Validity: This Quotation Estimate is valid for thirty (30) days from the date of issue. After this period, the Surgeon and the facility reserve the right to revise pricing based on current market conditions in Argentina Córdoba.
- Payment Schedule: A deposit of 40% of the total estimated amount (ARS 304,400.00) is due upon acceptance of this Quotation Estimate. The remaining 60% (ARS 456,600.00) is payable within five (5) business days following the completion of the surgical procedure and discharge from the facility.
- Accepted Payment Methods: Bank transfer (CBU/CVU), credit card (Visa, Mastercard, American Express), or cash at the clinic's administrative office in Córdoba, Argentina.
- Insurance Coordination: If the patient holds coverage through a prepagada (private health insurance) provider operating in Argentina Córdoba, our administrative team will coordinate pre-authorization and direct billing. The patient is responsible for any co-payments, deductibles, or services not covered under the insurance policy.
- Scope of Services: This Quotation Estimate covers the specific procedure and services listed above. Any additional procedures, complications, extended hospitalization, or emergency interventions that may arise during or after the surgery will be subject to a separate, additional Quotation Estimate approved by the patient or their legal representative prior to execution.
- Surgeon Availability: The surgical date is contingent upon the availability of the assigned Surgeon, the operating room, and the anesthesiology team. The clinic will confirm the definitive surgical date no later than seven (7) business days prior to the scheduled procedure.
- Cancellation Policy: Cancellation by the patient more than 72 hours before the scheduled surgery will result in a 10% administrative fee on the deposit. Cancellation within 72 hours will forfeit the full deposit. Cancellation by the clinic for reasons other than patient medical contraindication will result in a full refund of all amounts paid.
- Regulatory Compliance: All services are performed in full compliance with the regulations established by the Ministerio de Salud de la Provincia de Córdoba and the national health authority (ANMAT) in Argentina Córdoba.
- Confidentiality: All medical information contained in and related to this Quotation Estimate is subject to the patient's right to privacy under Argentine data protection law (Ley 25.326).
By signing below, the patient (or their legal representative) acknowledges receipt of this Quotation Estimate, confirms understanding of the estimated costs for the surgical procedure to be performed by the designated Surgeon in Argentina Córdoba, and authorizes the clinic to proceed with scheduling upon receipt of the required deposit. This signature does not constitute a binding contract for the surgical procedure itself; a separate informed consent form will be presented to the patient on the day of the procedure, at which point the Surgeon will review the specific risks, benefits, and alternatives in detail.
Patient / Legal RepresentativeName: Ricardo A. Fernández
DNI: 28.456.789
Signature & Date: _________________________ Authorized Representative — Clinica Médica del Centro
Name: Lic. Jorge P. Martínez
Role: Director Administrativo
Signature & Date: _________________________ ⬇️ Download as DOCX Edit online as DOCX
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