West Jefferson Physician Services Online Bill Payment




Please complete the form below.  Click on the Submit when finished.  We value your privacy.  Personal information will be used only for bill payment.  If you have any questions or would like to speak to a Billing Services Representative, please call (866)434-1545 ext 85294 .

Online Payment

Fields marked with an asterisk (*) are required. Please include either your email or telephone number if you would like a response.

This site chose VeriSign SSL for secure e-commerce and confidential communications.

  1. Information From The Bill
* Patient First Name:  
Click for example bill
 
* Patient Last Name:  
Click for example bill
 
* Account Number:  
Click for example bill
 
* Patient Date of Birth:
mm/dd/yyyy
 
Email:  
me@gmail.com
 
* Daytime Phone Number 1:
111-222-3333
 
Daytime Phone Number 2:   
111-222-3333
 
Comment:

  2. Select method of payment

   

                     
     

What is a CVV code?
CVV stands for Creditcard Validation (or Verification) Value. The CVV is a 3 or 4 digit code embossed or imprinted on the reverse side of Visa, MasterCard and Discover cards and on the front of American Express cards. Please note: The CVV code is not the last 3 or 4 digits of your credit card number.

This is an extra security measure to ensure that you have access or physical possession of the credit card itself in order to use the CVV code. For details on where to find your CVV code, please check below.

How to locate your CVV code?

VISA & MasterCard:
VISA CVV

Discover:
Discover ID

American Express:
American Express CID

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