MDPAY

MDPAY

For Questions Please Call: (512) 892-7076

555222

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locationKey	Item	Location	Amount
Total of Charge(s):			0

The payments will be processed separately per location using the payment method below.

The payments will be processed using the payment method below.

locationKey	Location	Status	Processing Amount	Charge
Total of Charge(s):				0

Search For a User

Account Number, Cellphone Number, or Primary Phone Number

Birth Year

Step One - Find Account

Please select the search type and enter your phone number or email address or patient ID

Phone Email PatientID

Your Validation

Please enter the year the patient was born (ex. 1985)

To ensure that you are the intended recipient of this message, we ask that you provide the year you were born so that we are able to verify your account. The notice you received about your account does not include any personal identification and was sent to the email address or mobile phone number provided by you during registration with our organization. This contact information may or may not be accurate. If you have any questions about our secure payment portal, please call our office at 931-526-8617 during normal business hours.

Your Outstanding Balance

Smith, Pablo

Pay Amount Owed

Pay a Different

Please enter a different amount then select continue.

New Amount Continue

Date of Service	Total Charge	Insurance / Adj	Previous Paid	Amount Owed	Amount Paying
			Total:	$0.00	Continue

Enter Your Payment Info

Process Secure Payment

Payment Information

Amount:

Credit Card Number:

Expiration Month:

Expiration Year:

Billing Information

First Name:

Last Name:

Mobile Number:

Email:

Address 1:

Address 2:

City:

State:

Zip:

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