Medical Records Invoice for the Netherlands

Medical Records Invoice Template for Netherlands

A standardized medical records invoice document designed for use in the Netherlands healthcare system, complying with Dutch healthcare regulations, privacy laws (AVG/GDPR), and financial requirements. This document serves as an official record of medical services provided and associated costs, incorporating necessary elements such as DBC/DOT codes, healthcare provider identification, and patient information. It is structured to meet both Dutch healthcare administration requirements and insurance processing standards, while maintaining patient data protection in accordance with Dutch privacy laws.

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What is a Medical Records Invoice?

The Medical Records Invoice is a essential document used in the Dutch healthcare system to formally record and bill for medical services provided to patients. This document type is specifically designed to comply with Netherlands healthcare regulations, including the Healthcare Market Regulation Act (Wmg) and the Medical Treatment Contracts Act (WGBO). It serves multiple purposes: documenting provided medical services, facilitating insurance claims, maintaining financial records for tax purposes, and ensuring proper medical administration. The invoice must include specific elements required by Dutch law, such as healthcare provider identification, treatment codes, and appropriate privacy notices, while adhering to GDPR/AVG requirements for handling personal medical data. It is commonly used by healthcare providers ranging from individual practitioners to large medical institutions, and must be retained for a minimum of seven years according to Dutch tax regulations.

What sections should be included in a Medical Records Invoice?

1. Healthcare Provider Information: Full legal name, address, medical license number, KvK (Chamber of Commerce) number, BIG registration number, and VAT number (if applicable) of the healthcare provider

2. Patient Information: Patient's full name, address, date of birth, insurance policy number, and patient ID (with minimal personal data in accordance with GDPR)

3. Invoice Details: Invoice number, date of invoice, and due date

4. Service Information: Detailed description of medical services provided, including dates of service, treatment codes (DBC/DOT codes), and healthcare provider reference

5. Financial Summary: Itemized list of charges, applicable rates, totals, and any insurance-related information

6. Payment Information: Bank account details, payment terms, and accepted payment methods

7. Legal Notices: Required statements about VAT exemption for medical services, privacy notice, and data processing information

What sections are optional to include in a Medical Records Invoice?

1. Insurance Coverage Details: Include when the invoice needs to be submitted to insurance, showing coverage percentages and patient co-pay requirements

2. Third-Party Payer Information: Include when payment will be made by a party other than the patient (e.g., employer, institution)

3. Treatment History Reference: Include when the invoice is part of an ongoing treatment series or references previous treatments

4. Special Arrangements: Include when there are special payment arrangements or installment plans

5. Referral Information: Include when treatment was based on referral from another healthcare provider

What schedules should be included in a Medical Records Invoice?

1. Detailed Service Specification: Detailed breakdown of services with applicable healthcare treatment codes and descriptions

2. Insurance Coverage Statement: Statement from insurance company regarding coverage and approved amounts

3. Payment History: For follow-up invoices, a record of previous payments and outstanding balances

4. Supporting Medical Documentation: Any required medical documentation to support the billing (with appropriate privacy measures)

Authors

Alex Denne

Head of Growth (Open Source Law) @ Genie AI | 3 x UCL-Certified in Contract Law & Drafting | 4+ Years Managing 1M+ Legal Documents | Serial Founder & Legal AI Author

Jurisdiction

Netherlands

Publisher

Genie AI

Document Type

Invoice Form

Sector

Sales

Cost

Free to use
Relevant legal definitions
Relevant Industries

Healthcare

Medical Services

Hospital Administration

Private Medical Practice

Dental Care

Mental Health Services

Physical Therapy

Specialized Medical Care

Primary Care

Healthcare Insurance

Medical Administration

Relevant Teams

Finance

Medical Administration

Billing

Compliance

Revenue Cycle

Medical Records

Patient Accounts

Healthcare Operations

Insurance Processing

Administrative Support

Relevant Roles

Healthcare Administrator

Medical Billing Specialist

Practice Manager

Financial Controller

Healthcare Provider

Medical Records Officer

Accounts Receivable Specialist

Compliance Officer

Medical Office Manager

Insurance Claims Processor

Healthcare Financial Manager

Medical Administrative Assistant

Revenue Cycle Manager

Medical Billing Coordinator

Healthcare Operations Manager

Industries
Teams

Employer, Employee, Start Date, Job Title, Department, Location, Probationary Period, Notice Period, Salary, Overtime, Vacation Pay, Statutory Holidays, Benefits, Bonus, Expenses, Working Hours, Rest Breaks,  Leaves of Absence, Confidentiality, Intellectual Property, Non-Solicitation, Non-Competition, Code of Conduct, Termination,  Severance Pay, Governing Law, Entire Agreemen

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