HSP - QuickPay | Health Services of the Pacific

PAY ONLINE

Step 1 of 2: Payment Information

Pay online with most major Debit Cards and Credit Cards using this QuickPay page. No login or signup needed.

Note: This payment portal is to pay fees due to Health Services of the Pacific (not the clinic, but to HSP main office).

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Get Started! Complete the basic info in Step 1 (this page) and check-out with your Debit Card or Credit Card in Step 2 (next page). The payments you make here will be credited to your account accordingly.

Who is making this payment?

* Means Required Fields

Making payment as *

Payer's Information

First Name *

Middle Name/Initial

Last Name *

Best Contact Number(s) *

Mobile Home Work

Area Code * - Phone Number *

+ Include Another Contact Number

Email Address *

Confirm Email Address *

Patient's Information

Yes, The Patient is the same as the Payer.

Patient's Full Name

First Name *

Middle Name/Initial

Last Name *

Patient's Date of Birth *

PAYMENT INFORMATION

Choose the item(s) for which you are making payment:

Medical transport

Click to SELECT this option

Click to UNSELECT this option

Optional: Enter Invoice or Bill Number (if you have it)

Optional: Comments about your payment

If you'd like, you can add information about your payment above.

$ Amount You Want To Pay *

*Minimum online payment is $5.00 per check-out.
**A 3.00% online convenience fee will apply to the total at check-out.
**Any overpaid amounts would be credited to the respective account and would not be refunded.

Patient copayments or co-insurance payments

Click to SELECT this option

Click to UNSELECT this option

Optional: Enter Invoice or Bill Number (if you have it)

Optional: Comments about your payment

If you'd like, you can add information about your payment above.

$ Amount You Want To Pay *

Invoice payments for services

Click to SELECT this option

Click to UNSELECT this option

Optional: Enter Invoice or Bill Number (if you have it)

Optional: Comments about your payment

If you'd like, you can add information about your payment above.

$ Amount You Want To Pay *

Equipment and supply purchases

Click to SELECT this option

Click to UNSELECT this option

Optional: Enter Invoice or Bill Number (if you have it)

Optional: Comments about your payment

If you'd like, you can add information about your payment above.

$ Amount You Want To Pay *

CONVENIENCE FEE WILL APPLY: A 3.00% Online Convenience Fee would apply to all online payments using Debit Card or Credit Card. This fee will be added to your amount already and you will pay it as part of the grand total while checking-out. You can see the total amounts in the next step.

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