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INTERNAL: TOKEN GENERATION AND GENERAL PAYMENTS

Pay Online

Step 1 of 2: Payment Information

Securely pay online using most major Debit Cards and Credit Cards. There are no additional fees for online payments.

Note: This payment page is only for TakeCare Insurance. Please do not pay FHP Health Center using this page.

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Get Started! Choose for what you would like to pay in Step 1 (this page) and check-out with your Debit Card or Credit Card in Step 2 (next page).

Payment Type

* Means Required Fields

Making payment as a *

Person completing form or point of contact:

Your First Name *

Your Last Name *

Member's Information

First Name *

Last Name *

Group or Subgroup ID

Group or Subgroup Name *

Best Contact Number(s) *

Area Code * - Phone Number *

+ Enter Another Contact Number

Email Address *

Enter Email Address Again *

Choose the item(s) for which you are making payment:

Pay Medical and/or Dental Premiums

Click to SELECT this option

Click to UNSELECT this option

Invoice/Bill Number

Add comments or description about your payment

$ Amount *

Minimum online Payment is $30.00.

Payment Options *:

Pay Now

Pay Now & Schedule Future Payments

Schedule Payments

The amount will be transacted on the spot, once you complete Step 2 (next page)

The amount will be transacted once you complete Step 2 (next page) and from there on the exact same amount would be transacted based on your scheduled payment preferences, using the same Debit Card or Credit Card for each transaction.

The exact same amount would be transacted based on your scheduled payment preferences, using the same Debit Card or Credit Card for each transaction.

Choose your schedule preference *:

Fix Date each month

In Intervals

Choose a fix date for each month *:

Choose number of days *:

Starting From *

Frequency *:

No Limit

Number of Transactions

End Date

No Limit, as long as a payment is owed

Number of Transactions; do not transact after this many times

End Date; do not transact after this date

Choose number of transactions *:

Choose End Date *

Make other payments besides Premiums

Click to SELECT this option

Click to UNSELECT this option

Describe for what you are making payment

$ Amount *

Minimum online Payment is $30.00.

Payment Options *:

Pay Now

Pay Now & Schedule Future Payments

Schedule Payments

The amount will be transacted on the spot, once you complete Step 2 (next page)

The amount will be transacted once you complete Step 2 (next page) and from there on the exact same amount would be transacted based on your scheduled payment preferences, using the same Debit Card or Credit Card for each transaction.

The exact same amount would be transacted based on your scheduled payment preferences, using the same Debit Card or Credit Card for each transaction.

Choose your schedule preference *:

Fix Date each month

In Intervals

Choose a fix date for each month *:

Choose number of days *:

Starting From *

Frequency *:

No Limit

Number of Transactions

End Date

No Limit, as long as a payment is owed

Number of Transactions; do not transact after this many times

End Date; do not transact after this date

Choose number of transactions *:

Choose End Date *

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TakeCare Online Bill Pay
TakeCare's Website

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ACCREDITATION ASSOCIATION
for AMBULATORY HEALTH CARE, INC.

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