Online Bill Pay – Salem Home Medical
* Patient Account Number:
The patient account number is required.
The patient account number may not contain a credit card number.
* Patient Name:
The patient name is required.
The patient name may not contain a credit card number.
* Birth Date:
The birth date is required.
The birth date is not valid.
The birth date may not contain a credit card number.
* Phone Number:
The phone number is required.
The phone number may not contain a credit card number.
* Payment Amount:
The payment amount is required.
The payment amount is not valid.
The payment amount may not contain a credit card number.
Technical Support
If you need technical support for this online payment processing application, please send an email to
billingquestion@salemregional.com
.