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Monroe County Hospital

Online Patient Payment Center

Welcome to Monroe County Hospital Online Payment Center. You may make payments on 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 at (478) 994-2521 Monday thru Friday between 8:00 a.m. and 5:00 p.m.

You may make payments to Monroe County Hospital using your credit card information in the designated fields. All payments are via secure server. Thank you for allowing us to serve you.

* Name Of Patient
Name of patient treated
* Account Number
Account number. (Should be located on your statement)
* Name of Payor
Payor's name as it appears on credit card
* Billing Address
Address where your credit card statement is mailed
* City, State, Zip
Please include your city, state, and five digit zip code
* Your E-Mail Address
Please provide a valid e-mail address.
* Amount of Your Payment
Please specify how much you are paying. Please use dollars and cents (eg. 00.00)
* Credit Card Type
Select type of credit card
Visa     MasterCard     Discover    
* Credit Card Number
Enter the 16 digit number just as it appears on card
* Credit Card Expiration Date
Enter credit card expiration in MMYY format (Example: 0106)
  Comments Or Messages Related To Your Payment