Mobile Phlebotomist DIY Invoice Form for Payment

Mobile Phlebotomy Invoice
Mobile Phlebotomy Invoice

Independent Contractor Invoice (sample)

  • To: (Payer) Barbara McKee - Case Manager
  • Address: __________________
  • Phone Number: ___________
  • Fax Number: ______________
  • EIN or Social Security Number: _______________


  • From: (Payee) Janet Brazille - CPT/Insurance Examiner
  • Address: ___________________
  • Phone Number: ______________
  • Fax Number: _____________
  • EIN or Social Security Number: _______________

Exam Date
Patient Name
Procedures
Lab
Bar Code #
Fee Charged
Notes
01/15/2013
Sanchez, Benjamin
Paramed/blood/urine
CRL
0234555
$40.00
Reimbursement for Mileage
 
 
 
 
 
 
 
01/16/2013
Johnson, Lilly
Paramed/blood/urine
Lab One
893005
$40.00
Reimbursement for Lab kit
 
 
 
 
 
 
 
01/17/2013
Gonzales, Sandra
Paramed/blood/urine
Heritage Lab
5543009
$40.00
Reimbursement for Mileage
 
 
 
 
 
 
 
01/17/2013
Gonzales, Michael
Paramed/blood/urine
Heritage Lab
5543008
$40.00
Completed husband and wife exam
 
 
 
 
 
 
 
 
 
 
 
 
 
TOTAL $ 160.00
 
 
 
 
 
 
Payer's Signature _________Date
 
 
 
 
 
 
Payee's Signature ________Date
Sample Paramedical Examiner Invoice

How to Write an Invoice for Paramedical Exams

Phlebotomist that work for paramedical exam companies are titled as: Mobile Phlebotomist, Insurance Examiners, and Paramedical Examiners. As Certified Phlebotomist we have to keep records of our own payments that are received by Paramedical Exam companies. Some paramedical exam companies will not pay you unless you send them an independent contractor's invoice.


The invoice format above is a good example of how to write a Mobile Phlebotomy Invoice.

  1. Start with the header for your invoice; you can center your heading.
  2. Write the information of the person you're doing the work for (paramedical exam company), full name and their title.
  3. Write the Mobile Phlebotomist/CPT (you) information, and include your title behind your full name.
  4. Fill in: the date of each exam, patient/insurance applicant name, procedure performed, laboratory name, bar code # on the lab kit label, flat rate fee you charged to the paramedical exam company, notes of things you want to remember or include to the invoice.
  5. Then add up your total once you're finish completing all the exams for that particular paypay period.
  6. Include your signature and the current date; if you're faxing the invoice you can also get the signature of the paramedical exam company's case manager.


Many Mobile Phlebotomist set their own "flat rate fees" for the insurance exams, since they are not working by the hour or by salary. It's a great idea to type up a "cost sheet" as well, for the type of insurance exams you're doing such as; paramed form/blood/urine, paramed form, or just urine.

To make your invoice look professional you can use Microsoft Word, Word Pad, Note Pad, Excel, etc. Once the pay period for all exams you complete is done, you can begin sending your invoice by faxing, mail, E-mail, or in person.

Some paramedical exam companies pay their workers according to pay periods, for example the 1st of the month through the 16th of the month can be a pay period, and then they will pay you after the 16th. Some paramedical exam companies pay as soon as the work is completed.


Definition

Independent Contractor - a worker who provides services to a company but is not an employee or agent of that company.


© Sabrina A. K.


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