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Millinocket Regional Hospital

MRH Online Patient Payment Center

Welcome to Millinocket Regional Hospital Online Payment Center. You may pay your hospital bills here by credit card only.
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 business office during working hours, Monday through Friday, 8:30 a.m. to 4:30 p.m..

Please call 207-723-7247 if you have questions about your account, a payment you wish to make, or a payment you have already submitted.

You may make payments to Millinocket Regional 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
* Contact Phone Number
  Comment
Primary Account Information
Please enter the primary account number and payment amount you wish to apply to the account.
* Account 1 Number
Enter the primary account number to which you wish to make payment.
  Acount 1 Name
(if different from Payor)
* Payment 1 Amount
Enter the amount to be applied to this account.
Secondary Account Information (Optional)
  Account 2 Number
  Account 2 Name
(if different from Payor)
  Payment 2 Amount
Additional Account Information (Optional)
  Account 3 Number
  Account 3 Name
(if different from Payor)
  Payment 3 Amount
Credit Card Information
Please confirm the payment total you wish to make today and provide the necessary payment information below.
* 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.)
* Email Address
* Billing Postal or Street Address
* Billing City
* Billing State
* Billing Zip Code
5 digit zip code