Online Bill Pay

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.

"*" indicates required fields

Name of Patient*

First Last

Contact Phone Number*

Email*

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.

Account 1 Name

if different from Payor

Payment 1 Amount*

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.

Total

Billing Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Credit Card*

Card Details

Cardholder Name

Mailing List

I want to stay informed. Please include me in your email communications about Millinocket Regional Hospital’s newly added services, upcoming events, current projects and more!

Online Bill Pay

Primary Account Information

Secondary Account Information (Optional)

Additional Account Information (Optional)

Credit Card Information

Billing & Insurance

Financial Assistance

Patient Information

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