Patient Notebook

Total Access Urgent Care

Welcome to Online Bill Pay. Please refer to your statement for Patient Name and Account Number.

13861 Manchester Road

Ballwin, MO 63011

Phone: (636) 556 - 0114

Make a Payment

Need to make a payment? Please fill out the information below and hit continue.

Error Summary

Please, correctly fill out all required fields.

1. Patient Information

First Name *

M.I.

Last Name *

Account # / PID / Invoice # *

Upper-Right Corner of Statement

Phone Number *

Email Address

A receipt will be sent to this email address.

2. Payment Amount

Amount

3. Payment Method

Credit/Debit Card

Name on Card *

Card Number *

Expiration Date *

Security Code *

Zip Code *

Cancel

Welcome to Online Bill Pay. Please refer to your statement for Patient Name and Account Number.

P (636) 556 - 0114

13861 Manchester Road

Ballwin, MO 63011