Payments

Do not use “refresh” button when using payment web form. It can cause/create duplicate payments to your credit card account.

Billing Information

First Name *

Last Name *

Email *
Address 1 *

City *

State *

Zip Code *

Patient Information

Patient First Name *

Patient Last Name *

Phone Number *

Service Location *

Reference Number *

Statement Number *

Account Number *: Help

Payment Information

Amount Total *

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Online Payment Disclaimer Notice

Graham Health System is pleased to be able to offer you the convenience of making secured online payments. Please be advised that making an online payment does not immediately change any disposition related to your account. We reserve the right to decline the acceptance of an online payment if your account is in default for any reason. We encourage you in addition to printing your receipt that you also verify wth us by phone or email that we posted your payment especially if the payment is made after normal business hours.

Our staff will respond to your account calls or email questions during normal business hours – Monday-Thurs., 8:00 am – 4:30 pm; CST: Friday 7:00 am – 3:30, CST excluding any regularly scheduled closing for holidays. You may call our office anytime for a listing of scheduled closings.

Please feel free to email your account questions to: grahamweb@grahamhospital.org

We accept the following payment types:

Accepted Credit Cards

Click here to review our Data Security policies

By checking this box you verify that you have read entirely this disclaimer and policies link above and agree with all of the content.

By clicking the Next button, you will be redirected to Rectangle Health to input your credit card information in a secure environment.

If paying on more than one account, please create separate transactions

All prices are shown in United States Dollars (USD)