Click-to-Pay

If you are currently enrolled in a payment plan and paying at least your previously agreed to minimum payment amount, this message does not pertain to you.  If you are NOT CURRENTLY ENROLLED in a payment plan and you are not paying the balance in full at this time, please call 614-866-0006 locally or 1-866-729-6847 out of area to make payment arrangements.  If not, your account may be placed with a collection agency. 

Please enter only the numbers of your account, as shown on your statement, to make payments.  Please do not enter any letters, dashes, or spaces.

Account Number:

Confirm Account Number:
Patient Name:
Amount being paid:
If payment has already been made to this account today, the maximum amount that can be paid is listed.  Note: the minimum amount you can pay by credit card online is $15.00.  Please call our Business Office at 614-866-0006 locally or 1-866-729-6847 out of area if you have any questions.  Thanks.
Billing First Name
Billing Last Name
Address
City
State
Zip (xxxxx or xxxxx-xxxx)
Billing Email Address
Confirm Billing Email Address
Phone(xxx-xxx-xxxx)
Payment method:
Credit Card E-Check
Card Account Number (e.g:4111111111111111)
Expiration Month
(e.g:12)
Card Expiration Year
(e.g:2020)
Card Verfication Number
(e.g: See picture alongside)