Receipts/payments in Italian private clinic

Hello all,

I really appreciate the knowledge of many on here and so I hope I can ask a question.

I underwent four separate surgeries with an Italian doctor working in a private healthcare clinic in Italy. I'm from abroad and since I don't have a bank account with an Italian bank, I paid the doctor in cash (I did pay the regular/full fees of course, including surgery fees and facility fees). I saw the doctor while I was worried about my concerns and so I didn't dare to be too critical.

However, after the surgeries the doctor gave me a handwritten note that stated that I had paid him X euro's. However: on several occasions this handwritten note listed an amount that was far less than what I had in fact paid him. After the third surgery I didn't receive a handwritten note or anything that proved I had paid him anything. When I asked the doctor for it when I saw him for the fourth surgery he added the amount I paid for the third surgery to the handwritten "receipt" of that fourth surgery. He also gave me the handwritten note for the second surgery at the same time more than six months after that surgery (upon my request as I again hadn't received any proof of payment) this time also listing the wrong surgery date and the wrong amount. The private clinic that he works for in addition only gave me a printed out receipt of two surgeries (saying they didn't have any receipt in their system of the other two surgeries). Again: the amount listed on those receipts is not even half of what I paid (and it is also the incorrect amount if I add up the amount the surgeon wrote on the handwritten notes). Frankly: it seems like a mess and looking at those notes it is impossible to see what I in fact paid.

All in all, I'm worried. Not in the least since I ran into other more serious issues with this surgeon. I have asked the doctor and the clinic why I receive such "receipts" but their response is dismissive. They make me feel as if I am rude for asking, telling me they won't help me anymore. I'm not sure what to think anymore and don't dare to ask any further. But could anyone please explain how this works and if it is normal to receive such receipts in an Italian clinic? Thank you very much! I appreciate your help very much!