Mediatrix Hospitalization

HOSPITALIZATION PAYMENT

1. PATIENT INFORMATION

* Please refer to the statement of Account you are holding.

2. BILLING INFORMATION: (Philippine Peso)

*Additional 0.3% for Credit Card Payment will be included.

**Additional Php 25.00 for Bancnet, Dragonpay and Gcash will be included.

Amount to be paid in PHP :

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“The official Statement of Account is available from our Billing window”

SAMPLE ONLY

All Personal Data of our customers submitted on Mary Mediatrix Medical Center Online Payment System
shall be used for payment guidelines and shall be kept in the aforementioned system in accordance to the Data Privacy Act of 2012.