Patient Bill Payment – Kona Community Hospital

Thank you for using Kona Community Hospital's online bill payment system, an easy and secure way to pay your medical bills.

Please complete the required information form below and click "SUBMIT" at the end of the page. A Patient Financial Services representative will process your payment and you will receive an e-mail notification that your payment has been completed. Please enter your billing information as it appears on your account.

If you have questions or need additional assistance regarding your hospital bill, please contact our Billing office by CLICKING HERE.

* Denotes Required Field

Patient Information
Patient Statement Number*
Patient Name*
Payment Amount*
Patient Contact Information
Name*
First Name Last Name
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Home Phone*
Alternate Phone
Email*
Billing Information
Credit Card*

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Billing Address*
Billing address same as above

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Additional Information
If you have questions or need additional assistance regarding your hospital bill, please contact our Billing office by CLICKING HERE.

Patient Information

Patient Contact Information

Billing Information

Additional Information