Dental Doctor Checkup Invoice Template

By | May 15, 2015

When a patient with dental condition visits a dentist, he is required to pay for the checkup, operation and medicine prescribed by the dentist. If the patient doesn’t have medical insurance or social security, he is asked to pay the fee of the dentist in cash where on the other hand, when a patient does have the insurance or social security, the dentist is paid by the insurer or the employer of the patient. The document that includes the charges of the dentist is known as the dental doctor checkup invoice.

Brief description of Dental Doctor Checkup Invoice:

There is a huge difference in the thinking style of people in the Asia and in America along with the fact that they live their lives in a completely different way. In the same sense when we talk about social security and medical insurance, almost every person in America has it. This means that when a person visits a doctor or a dentist, he doesn’t need to pay them anything but their insurance or social security covers the expenses.

When a patient has social security or medical/dental insurance, the dentist can ask him to pay for the expenses and then receive these expenses by his employer or insurer with the invoice that the dentist will issue to the patient or the dentist can just issue the invoice to the patient and receive his charges from the insurer or social security department. In both cases, it is very important for both the dentist and the patient to submit the checkup invoice with the insurer so that the expenses can be verified for payment purposes.

Here is preview of a Free Sample Dental Doctor Checkup Invoice Template created using MS Word,

Dental Doctor Invoice Template

Essential elements to include in the Dental Doctor Checkup Invoice:

  • Name of the dentist with complete address and contact info
  • Name of the clinic or hospital where the dentist works
  • Name of the patient who visited the dentist for checkup
  • Reference number of the invoice
  • Date on which the dentist is sending the invoice
  • Date on which the patient visited the dentist
  • Social security number of the patient
  • Detail of the checkup of the patient
  • Charges for the checkup of the patient
  • Due date for the payment of the charges for the dental checkup
  • Signature of the dentist

Tips for creating a Dental Doctor Checkup Invoice:

  • Clinic/hospital name and contact info:
    Start the invoice by putting your clinic or hospital name at the top along with your address and contact numbers.
  • Patient details:
    Below that, include the details of the patient i.e. name, social security number, insurance provider name, date on which he visited etc.
  • Description of dental checkup with separate procedures:
    In this section, you need to enlist the dental services you provided to the patient i.e. cavity filling, cleaning, braces, root canal etc.
  • Charges for the checkup:
    This is the section in which you are required to mention the total charges for your services i.e. the money that the patient or his insurer owes you.
  • Due date for the payment:
    Right before you sign the invoice and close it, mention the date before which the patient is asked to make the payment for his dental procedure.

Here is download link for this Dental Doctor Checkup Invoice Template,

Download Dental Doctor Checkup Invoice Template

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