BEDFORD PARK DARIEN ELK GROVE MELROSE PARK WHEATON 847-616-2000
Welcome to the Online Patient Payment System
Our medical office has the ability to accept secure online credit card payments through the Advanced Data Systems payment portal. After your information is verified directly with our practice records, you will be prompted to enter your credit card details along with a payment amount.
If you have any questions regarding your billing statement, please contact us directly at: (847) 616-2000
Welcome to the Online Payment Portal for Bright Light Medical Imaging
you can enter your account # like so 12345/1 to gain access to portal
Verify Patient Information
Step 1 Patient Information
Please type in the patient's information as found on the billing statement.
(Optional)
This information is used to verify that the account number entered above belongs to you or an immediate family member. By verifying the patient's data matches the provided account number, the possibility of an erroneous payment is minimized.
Collections
Collection Balance:
Credit Card Information
Card on File: N/A
Step 2 Credit Card Information
0
Patient Bal: $0.00
In the form below, please type in the credit card holder's information.
Use Card on File
Store this card for future use
$
Payment Receipt
Step 3 Payment Status
How is my information secured?
- This website uses Transport Layer Security (TLS) to encrypt data between your computer and our servers. - Your account information is verified with the doctor's office prior to submission in order to eliminate the possibility of erroneous payments. - In partnership with TSYS Secur-ePayment (TSEP) your credit card information is passed directly to the credit card processor and never accessible by Advanced Data Systems or the medical practice.
Online Payment Confirmation
Your online payment confirmation is enclosed
Thank you for your payment!
Your payment in the amount of ${amount} was successfully processed on {timestamp}. The reference number for your transaction is {reference}.
{patient_name} - {acctpat_no}
Online Bill Payment - {auth_code}
Total
${amount}
This payment has been successfully posted to your account.
Questions?
If you have any questions regarding your payment, please contact the office directly during regular business hours. Thank you!
Bright Light Medical Imaging
Tel: (847) 616-2000
This e-mail was sent from a no-reply address.
MedicsPremier Patient Portal
(Optional)
- This website uses Transport Layer Security (TLS) to encrypt data between your computer and our servers.
- Your account information is verified with the doctor's office prior to submission in order to eliminate the possibility of erroneous payments.
- In partnership with TSYS Secur-ePayment (TSEP) your credit card information is passed directly to the credit card processor and never accessible by Advanced Data Systems or the medical practice.
