Online Patient Payment Center

Welcome to WestHealth's online payment center. You may pay for your services provided at WestHealth here by Credit Card.

For your convenience please fill out the payment form below. Please note: to pay for more than one patient, you will need to submit each patient's payment seperately.

Name of Patient * (as it appears on the statement)
WestHealth Account Number or Patient Date of Birth *
Credit Card Type *
Credit Card Number*
CID Number (Last 3 digits on the signature line on the back of the card)*
Credit Card Expiration *	Month: Year:
Credit Card Holder Name *
Cardholder Street Address *
Cardholder City *
Cardholder State *
Cardholder Zip *
Cardholder Phone *
Total Amount of Payment *
Date of Service to Apply Payment - (optional) We will apply your payment to the oldest balance due if not stated here.
Comments/Instructions
* required field

Online Payments

All Information will be kept secure and confidential.

All payments are via a secure server.

For questions or assistance in completing information, please contact:

Patient Account Services
763-577-7070
Hours: Monday - Friday,
8:00 a.m. - 4:30 p.m.