Chiropractor Invoice Template

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The Chiropractor Invoice Template allows a well-organized display of material necessary to collect payment for chiropractic consults, examinations, or adjustments. Naturally, the Patient or the Client will require some documentation regarding the Chiropractor’s service since such paperwork can be useful if seeking reimbursements, proving that treatment was needed and sought, or in making sure that one’s expense records are complete. An invoice template will satisfy these needs and benefit the Chiropractor Office by removing the burden of designing an invoice every time a Patient or Client must be billed.

Salary & Hourly Wage ($/hr)

  • Salary: $71,410/yr (source: BLS)
  • Hourly Wage: $34.33/hr (source: BLS)

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How to Write in PDF and MS Word

Download: Adobe PDF & Microsoft Word (.docx)

Step 1 – Acquire Your PDF Or Word Chiropractor Invoice Template

Obtain the Chiropractic Invoice Template using the links provided above or the buttons under its preview. These items will give you the ability to save this invoice as either an “Adobe PDF” template or a “Microsoft Word (.docx)” template.

 

Step 2 – Introduce The Chiropractic Practice Sending This Document

Identify the Chiropractic Practice or the Chiropractor sending this invoice at the top of the page. This requires that you delete the phrase “Company Name” in the first text box then replace it with the formal name of the Practice.  Next, the “Name” of the Chiropractor or that of the Practice Employee handling this payment request must be documented. Do so by entering it directly after the text label “Name.”  The Chiropractic Office’s formal business address will be a requirement of this invoice and should be presented along with the identity of the Sender. Thus, using the “Street Address” line for the staging area, display the building number, street road or avenue name and any suite, unit or PO Box Number needed on the first line of the Chiropractor (or Practice) mailing address then produce the “City, State, Country” and “Zip Code” on the lines that follow.  This invoice requires only a couple of more contact items to complete this section. Both of which will have a separate area of display. Dispense the Practice or Independent Chiropractor’s business line immediately after the text label “Phone” and the appropriate Chiropractic Practice “E-Mail” on the line below that. 

 

Step 3 – Attach The Chiropractor’s Invoice References

It will be imperative for this paperwork’s function that it be assigned a specific point of reference so that it may be found and updated easily with the Patient or Paying Client’s response. A widely accepted tool for invoice tracking is the invoice number assigned to it. Use the “Invoice #” line in the shaded area to display this information for the Patient’s reference as well.  On the right will be a reserved area for the invoice “Date.” Furnish the calendar “Date” marking this document’s first day of effect on this line. 

 

Step 4 – Name The Patient Or Paying Client

The full name of the Paying Client must be dispensed to this paperwork. This is often the same as that of the Patient’s however, if the Chiropractic Practice or Chiropractor accepts insurance this may be a Business Entity. Regardless of who the Chiropractor intends to collect payment from, that Party’s identity must be solidified. The series of labeled spaces (below “Bill To”) are set to receive and attach the “Name” of the Paying Client then this Party’s full billing or mailing address. Furnish the blank lines “Street Address” through “Zip Code” with this material accordingly.   

 

Step 5 – Define The Consultation, Examination Or Adjustment Requiring Payment

The table occupying the next area of this document seeks a basic report on the chiropractic services received. The “Description” column will refer to the “Date” and topic of the service. You may list services such as consultations, examinations, therapies, and adjustments on a row by row basis and may separate each entry by topic, date, or both.  The number of billable “Hours” the Chiropractic Practice or Chiropractor intends to bill for should be documented. Place this number in the second column. 

 

Step 6 – Account For The Total Payment Expected By The Chiropractor or Chiropractic Practice

The next part of this table shall request a specific pay rate for the Chiropractor’s work. Record this as a dollar value to be paid for every hour worked.  This invoice will now need the result of the “Hours” entry multiplied with your record “$/Hour.” This result must be placed in the “Amount” column on the same row as the numbers you used in your calculation.  The Chiropractic Practice’s “Subtotal” for this invoice represents the sum of all amounts owed before any taxes are added. Report the sum of the “Amount” column in the “Subtotal” field at the bottom.  Some states may require a tax on the chiropractic services performed and of course certain products are subject to sales tax. Input the full amount owed in taxes based on the “Subtotal” in the field labeled “Tax.”  The “Total” owed by the Patient or Chiropractic Practice Client is the sum of the Chiropractor’s “Subtotal” and taxes. Document this sum in the final field of the “Amount” column. 

 

Step 7 – Discuss The Due Date For The Chiropractor’s Total

The Chiropractic Practice should let the Client know when this invoice will be late if ignored or unpaid. This requires that the total number of “Days” after the invoice that a lateness status is assigned be recorded. Place this number on the blank line attached to the word “Days” in the “Payment Is Due” statement. 

 

Step 8 – Additional Chiropractor Comments Or Instructions Can Be included

The final area of information remains open-ended for your convenience. Any subjects left uncovered may be presented after the “Comments Or Special Instructions” statement near the bottom of the invoice. 

 

How to Write in MS Excel

Download: Microsoft Excel (.xlsx)

Step 1 – Access The Excel Template Needed To Bill Chiropractic Patients or Clients

The displayed template is available as an Excel sheet by clicking on the “Microsoft Excel (.xlsx)” link above of choosing the “Excel” button presented with the image.

 

Step 2 – Name The Chiropractic Practice Invoicing The Concerned Patient

The first column requires the Chiropractic Practice be clearly identified by name and contact information. For this effect, cell A1 is held by a generic image that should be removed then replaced with the image file containing the Chiropractic Practice’s logo.  The next two fields beneath this logo shall require the Chiropractic Practice’s “Company Name” and the Chiropractor’s “Name” produced as their respective content. Supply these items of identification to these fields as requested.  Cell A4 is set to display the building number/street/unit number in the first line of the Chiropractic Practice’s mailing address. Replace the term “Street Address” in this cell with this information.    The two fields following the “Street Address” intend to display the “City, State, Country” then the “Zip Code” you report (in cells A5 and A6) as the remainder of the mailing address maintained by the Chiropractic Practice.  This header’s final requests both concern the Chiropractic Client’s ability to communicate with the concerned Practice. Thus, submit the Chiropractic Practice’s “E-Mail” and “Phone” number to cells A7 and A8.   

 

Step 3 – Identify This Correspondence As A Bill From The Chiropractic Practice

The paperwork being developed should have its own manner of reference. Ideally, this reference item will be entirely distinct in your filing system and considered the “Invoice #” attached to this bill. Supply this number in cell F4.  If the Chiropractic Practice intends to use the current “Date” as the Invoice “Date” then you may proceed to the next section. This task has been handled by cell H4. If a different “Date” should be this document’s first active day, then replace the contents of cell H4 with the preferred Invoice “Date.” 

 

Step 4 – Obligate The Chiropractic Client To Pay This Bill

This spreadsheet makes a deliberate point of assigning one entity as its target. Satisfy this requirement by inputting the full “Name” of the Chiropractic Client meant to receive and pay this bill.    After naming the Chiropractic Client, furnish billing address where this Party receives mail. Use the fields in cell A12, A13, and A14 to furnish this material.   

 

Step 5 – Discuss The Chiropractic Services Made Available To The Patient

A brief discussion will be expected to describe which chiropractic services were received by the Patient and/or when these services occurred. Cell A17 is the first cell in the invoice table where you should display this report. It is strongly recommended that you report only one item per row in this section.  The number of “Hours” being billed for the session discussed in the previous column must be presented as well. Thus, continue across the row to cell A18, in the “Hours” column, then fill in the total number of “Hours” the Chiropractor worked on or for the Patient.   

 

Step 6 – Bill All Of The Provided Chiropractic Services

Cell G17 on the row we are working on will allow us to complete the final column as well. Input the hourly pay rate in this column (“$/Hour”) the Chiropractic Client must pay for every row where you discussed provided chiropractic services. The dollar value entered here will complete a formula used to dispense the totals required in column H.  In some cases, sales tax may need to be assessed to any products that may have been purchased (i.e. a book or series of instructional lessons). If a sales tax must be added to the chiropractic “Subtotal,’ calculate it according to the concerned tax entity’s regulations then submit it in cell H28.   

 

Step 7 – Attach The Grace Period To This Payment

Notice that the Chiropractor’s “Total” is the final cell of the table but this invoice shall continue to a statement in cell A30. It would be considered wise to incorporate this statement to the invoice being delivered by replacing the brackets (just before the word “Days”) with the maximum number of “Days” the Chiropractic Client is given to pay this bill before being subjected to further requests. 

 

Step 8 – Continue With Instructions Or Appropriate Content As Needed

If there are issues or topics that should be covered in addition to the above invoice material then, locate cell A31. The “Comments Or Special Instructions” field will accept additional content as required.

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