I WOULD LIKE TO

Online Bill Pay - Mon Health Medical Center

We gladly accept online payments of $20.00 or more.  Please call Patient Accounting at 304-598-1560 for payment options of less than $20.00. 

Payments processed after 6:00 pm ET will be posted with tomorrow’s payments.

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Required Fields have a red star in front of them.  Click underlined text for more information. 

Patient Information

* Account Number:
No dashes, please
* Verify Account Number:
  (type it in again, please)



* First Name:


* Last Name:



Payment / Card Holder Information

* First Name:


* Last Name:

* Email Address:


* Daytime Phone:

 
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* Billing Address:


* Billing City:


* Billing State:


* Billing Zip:



* Card Type:


* Card Number:
* Security Code:

 
* Expiration Date:
-


* Payment Amount :