Question about my bill Please use this form to send us a question or concern about your bill. A customer service representative will contact you at the daytime phone number provided within two business days. Should you wish to speak to a customer service representative directly, please call us between 8 a.m. and 4:30 p.m. Monday through Friday at 812.801.0161. *First name Required *Last name Required Patient name (if different than you) Account number (located on your bill) *Birth date Required *Date of service Required *Insurance Required Select... Commercial Medicaid Medicare No insurance *Address Required *City Required *State Required Select... Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming *Zip Required *Email address Required *Daytime phone Required *Question or message Required Submit
