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Introduction

Medical Invoice Template / Medical Billing Template are designed specially for small medical practice businesses, especially for those who offer medical care for infants, children and adolescents. On the body of the invoice form, the medical invoice form / medical billing form details not only the billing items, but also insurance etc.

In detail, the body of the free medical invoice form including the following additional fields: Date of service (date field), additional payment fields that are line itemed next to description - Total Fee (editable within invoice), CoPay (editable within invoice), Insurance Reim (editable within invoice), Ins Contract Adjust (editable within invoice), Patient Responsibility (auto-calculates as = Total fee - CoPay - Insurance Reim - Ins Contract Adjust). If a large and expensive practice management application is not suitable for you, this free and easy to use invoice template created by uniformsoft.com helps you create professional invoices in minutes.

On the top of invoice form, you can find a default LOGO image and information about your company / organization. At the right-hand there are two fields that appear on most of the invoice formats, date and invoice#.

Since this invoice template is designed for those who offer medical care for infants, children and adolescents, the 'Bill To' and 'Ship To' fields found on a general invoice template are utilized a little differently. The 'Bill To' would represent the head of household account member (i.e. Dad), while 'Ship to' would be the actual patient information - This allows you to easily deal with families with multiple children.

On the bottom of the invoice form there are a group of checkboxes let you choose the payment type, Check, Visa, MasterCard, Amex, Discover. The signature and the additional 'date' field are for handing writing.

Notes to Invoice Manager users:

  • An invoice is marked as 'paid' if the oknBalanceDue cell is zero. By default, a paid invoice is not editable. Contact us for a hidden option if you need to be able to edit paid invoice.
  • In this invoice template, if you fill in the 'card holder name', the invoice will be paid.
  • On the Statement report, the 'payment total' calculation will not work. I recommend you to remove this part from your statement report. This is because the invoice template allows you to enter payment information on the invoice form; there are no separate payment records.

 

Screenshots

Tip: Enlarge an image by clicking on it.

Medical Billing Form - printed document

This is how medical invoice template will look like when you open it with Microsoft Excel.

Medical Billing Form - Excel worksheet

The following Uniform Invoice Software version of Medical Invoice Template should be used with Uniform Invoice Software installed.

Medical Billing Form - Uniform Invoice Software edition

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