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You have elected to make a secure payment from our website. For your protection you will be asked to provide a few pieces of information and then proceed to our online payment authorization form.

You will need a few pieces of information before continuing. This information can be found on your patient statement.

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Billing Dept:                                                                                Mailing Address:
Phone:      704-973-5500 Within NC                                      PO Box 32187
Phone:      866-389-5500 Toll Free                                        Charlotte, NC 28232
Fax:          704-973-5518

Patient Name
 

First*, MI,  Last (Surname)*, Suffix ie. Jr. Sr. II, etc.
 
Patient Account Number*
Note: Please refer to your statement for this information
 
 
Cardholder name (if other than patient name listed above)
 

First*, MI,  Last (Surname)*, Suffix ie. Jr. Sr. II, etc.
 
Statement Date *

Note: Please refer to your statement for this information. It is located half way down the page on your statement towards the right side of the page along with your account number.
  (MM/DD/YYYY)
 
Payment Amount*
Please specify the amount of your payment in US Dollars and cents. For example, if your payment is $100 (one hundred dollars) then please enter 100.00 in the field below. Please do not use any special characters.
  $
 
   
Announcements

Pathology Associates Services is now
 

Please visit our new website: www.celligent.net