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Liberty Regional Medical Center

Online Patient Payment Center

Welcome to Liberty Regional Medical Center Online Payment Center. You may pay your hospital bills here by credit or 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 business office during working hours.

You may make payments to Liberty Regional Medical Center using your credit or debit 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.
* Account Number
Account number. (Should Be Located On Your Bill, This information is helpful to post payment to correct patient visit.)
* Phone Number
Number where you can be reached.
  Comments Or Messages Related To Your Payment
* Cardholder First Name
The first name of the account holder as it appears on the credit card.
* Cardholder Last Name
The last name of the account holder as it appears on the credit card.
* 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