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La Paz Regional Hospital

Online Patient Payment Center

Welcome to La Paz Regional Hospital Online Payment Center. You may pay your hospital bills here by credit card.
For your convenience please fill out the below payment form. All information will be kept secure and confidential. For more information you may call our business office during working hours.

You may make payments to La Paz Regional Hospital by submitting your credit card information in below fields. All payments are via secure server. Thank you for allowing us to serve you.
* Account Number
* Patient Name
Name of patient the payor is paying the bill for (first name followed by last name).

Example: John Smith
Billing Information
* Name of Payer
Name of person paying the patient's bill (first name followed by last name).

Example: John Smith
* Amount of Payment
Format: 45.67 (Include decimal and cents. Do not use a dollar sign.)
$
* Card Number
* Expiration Date
* Card Code Verification Number
The three digit number on the back of your card. (Four digit code on the front of American Express.)
* Billing Postal or Street Address
* Billing City
* Billing State
* Billing Zip Code
5 digit zip code