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Stonewall Jackson Memorial Hospital

Online Patient Payment Center

Welcome to the Online Payment Center. You may pay your hospital bills here by credit/debit 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 between 8am to 4pm Monday through Friday at 304-269-8144.

You may make payments to the Hospital using your credit/debit card information in below fields. All payments are via secure server. Thank you for allowing us to serve you.
* Name Of Patient
First name followed by last name. For example: John Smith
* Patient Account Number
Patient Account Number is 6 digits and is located on the top right hand corner of your statement right below patient's name.
* Phone Number
(xxx) xxx-xxxx
* Your E-Mail Address
Please Provide An E-mail Address.
  Comments Or Messages Related To Your Payment
Billing Information
* Billing Name
First name followed by last name. For example: John Smith
* Credit Card Type
* 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