Medical Bill

Templates

Medical Bill

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Healthcare

Use this template

Datapoint

Description

This is some text inside of a div block.

Patient Name

Full name of the individual receiving medical services.

Patient Identifier / Account Number

Unique ID or reference number associated with the patient in the billing system.

Date of Service

The date the treatment or service was provided.

Facility Name

Name of the hospital, clinic, or medical provider issuing the bill.

Facility Address

Mailing address of the provider or billing entity.

Billing Provider / Physician

Name of the doctor or specialist responsible for treatment, if applicable.

Treatment Type

Broad category of medical service provided (e.g., Diagnostic, Therapeutic, Preventive).

Treatment Description

General description of the nature of the service or medical intervention.

Service Code / Procedure Code

General or alphanumeric code used to classify the service (e.g., CPT/HCPCS/ICD codes).

Treatment Cost

The billed amount for the treatment or service.

Insurance Adjustment

Any amount reduced or adjusted based on insurance contracts.

Patient Responsibility

Out-of-pocket cost the patient is expected to pay (e.g., co-pay, deductible, or uncovered balance).

Payment Method

Method used or requested for payment (e.g., credit card, insurance, payment plan).

Total Billed Amount

The full total amount billed before adjustments.

Total Amount Due

Final amount owed by the patient after all insurance and discounts are applied.

Billing Date

Date on which the bill was issued or generated.

Due Date

Deadline by which the payment must be made.

Medical bills outline patient, provider, service, and cost details necessary for payment processing and insurance coordination. Feathery’s AI extraction engine captures the patient’s name, identifier or account number, date of service, facility name and address, billing provider, treatment type and description, and service or procedure codes. It also extracts treatment costs, insurance adjustments, and the patient’s financial responsibility, including co-pays, deductibles, and uncovered balances.

The engine retrieves total billed amounts, final amounts due, billing and due dates, and specified payment methods. This template is ideal for healthcare providers, insurers, and revenue cycle teams seeking to automate medical bill intake, accelerate claims processing, improve payment accuracy, and reduce manual data entry.

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