Patient Account Number - last four digits will change for each visit with exception of recurring accounts.
Date treatment began or date of admission for in-patient (hospital) treatment.
Date of the current statement.
Guarantor or person responsible for payment of entire bill or portion of bill not covered by a third party or health insurance company.
Payment amount expected from patient or guarantor. If empty, no payment is expected at this time.
Date payment must be received to ensure credit before next billing cycle.
Type of service.
Charges incurred during out-patient visit, in-patient stay, or recurring instances of treatment; Please note: (a) The initial in-patient statement will show a summary of charges by department; a detail of charges is available on request by calling (757) 233-4500. (b) The initial out-patient statement will show a detail of charges for the visit. (c) Follow up statements will show a "balance forward" and will indicate any payments or adjustments made during the billing cycle.
Name of facility where services were provided or rendered.
Phone number for Billing Customer Service or person handling this account.