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Cameron Memorial Community Hospital

Online Patient Payment Center

Welcome to Cameron Hospital Online Payment Center.
You may pay your hospital bills here by Credit Card/Debit Card.

For your convenience please fill out the payment form below. All information will be kept secure and confidential. For more information you may call our Financial Services department at (260)665-2141, Ext. 5362.

You may make payments to Cameron Memorial Community Hospital using your credit card information in the fields below. All payments are via secure server.

Thank You for Allowing Us to serve you!

* Name Of Patient
Name of Patient Treated.
  Patient Number (optional)
Should Be Located On Your Bill. This is Optional.
* Name of Payor
Payor's Name on Credit Card /Debit Card.
* Billing Address
Address Where Your Credit Card or Bank Account Statements Are Mailed.
* City, State, Zip
Please Include Your City, State, and Five Digit Zip Code.
  Phone Number
Please Enter Your Phone Number (xxx-xxx-xxxx).
* Your E-Mail Address
Please Provide An E-mail Address.
* Amount of Your Payment
Please Specify How Much You Are Paying. Please Use Dollars and Cents.
* Credit/Debit Card Type
Please select Credit/Debit Card Type.
Visa     MasterCard     Discover Card    
* Credit/Debit Card Number
Input The 16 Digit Number Just As It Appears On Card.
* Credit/Debit Card Expiration Date
Example: 00/00
* Credit Card Authorization Number
Please Enter the Last 3 Digits of the Authorization Number Found on the Back of Your Card.
  Comments Or Messages Related To Your Payment