Binson's Online Bill Pay

Please fill out the information below in order to pay your bill online. If you have a MyBinson's account, you can sign in to complete the form even faster.

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If you have any questions or concerns about a payment you'd like to make, please contact our billing department at 1-800-922-6528

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Patient

Account #* Where is it?

First Name*

Last Name*

Address*

City*

State*

Zip*

Email*

Payment Information (Billing)

Billing same as Patient Address

First Name*

Last Name*

Address*

City*

State*

Zip*

Phone*

Payment Type*

Credit Card

Check

Amount*

Additional Information
Invoice # , Date of Service , or Comments

* You must complete the bold fields in order to submit your information.

*Do not press submit more than once*