paymymedicalbill.us.comPayment Form DataSearch Medical

Your browser does not support JavaScript. Please enable JavaScript in your browser to take full advantage of the features that this website offers. Secure Payment Form DataSearch Medical Contact Us: 1-877-293-0205 cs@datasearchinc.com Welcome, Payment Type Payment Information Confirmation Select Payment Type: E-Check Credit Card To make sure a secure payment to your account, please be sure to enter the valid account number you received from us. If you do not know your account number please Contact Us to obtain your account number before proceeding to make a payment. Failure to enter your valid account number may cause a significant delay in processing your payment. E-Check Single Payment Single Future Payment Bank Account Information * Account Holder Name * Routing Number * Account Number * Account Type select Checking Savings Bank Account Information Your bank account information is located at on the bottom of your check as illustrated below. Credit Card Information * First Name * Last Name * Billing Street Address * Billing City * Billing State * Zip Code * Card Number * Expiration Date select 1 2 3 4 5 6 7 8 9 10 11 12 / select 2013 2014 2015 2016 2017 2018 2019 2020 2021 2022 2023 2024 2025 2026 2027 2028 2029 2030 * Card ID (CVV2/CID) Card ID / CVV2 CVV stands for Card Verification Value. It is a 3 or 4 digit number located as shown on the picture below. Please enter this number in the field below. Payment Receipt Email Receipt To: (Optional) Payment Information * Transaction Date RadDatePicker Open the calendar popup. Calendar Title and navigation << < January 2020 > >> January 2020 S M T W T F S 53 29 30 31 1 2 3 4 2 5 6 7 8 9 10 11 3 12 13 14 15 16 17 18 4 19 20 21 22 23 24 25 5 26 27 28 29 30 31 1 6 2 3 4 5 6 7 8 * Amount * File Number * Guarantor name/Facility Name/Acct # * Billing Phone Number * Required...