Online Payment - West Hawaii Region

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(Required)

Patient Name(Required)

Payment Amount(Required)

Patient Contact Information

Name(Required)

First Name Last Name

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone(Required)

Alternate Phone

Email(Required)

Billing Information

Credit Card(Required)

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Billing Address(Required)

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.