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pennstatehealth.ci.healthpay24.cloud Open in urlscan Pro
2606:4700::6812:cb  Public Scan

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Submitted URL: https://pennstatehealth.ci.healthpay24.cloud/
Effective URL: https://pennstatehealth.ci.healthpay24.cloud/account/login?ReturnUrl=%2F
Submission: On November 30 via manual from US — Scanned from DE

Form analysis 2 forms found in the DOM

POST /account/quicklogin/

<form class="recaptcha-form" style="margin-bottom:30px;" method="post" autocomplete="off" autocorrect="off" autocapitalize="on" action="/account/quicklogin/" novalidate="novalidate">
  <div class="card-header">
    <div class="card-title">
      <div class="title">Quick Pay</div>
    </div>
    <div style="flex-grow:2;"></div>
  </div>
  <div class="form-group">
    <div class="input-field col s12">
      <input type="text" data-val="true" data-val-required=" " id="BillingInfo" name="BillingInfo" value="">
      <label for="BillingInfo">Encounter # / Receivable Group ID or Statement / Bill Number</label>
    </div>
    <div class="input-field col s12">
      <input type="text" data-val="true" data-val-required=" " id="LastName" name="LastName" value="">
      <label for="LastName">Guarantor's Last Name</label>
    </div>
    <div class="input-field col s12">
      <input placeholder="MM/DD/YYYY" type="text" data-val="true" data-val-date="Use format: MM/DD/YYYY" data-val-requiredif=" " data-val-requiredif-dependentpropertyname="Identity_BirthDate" data-val-requiredif-requiredwhenvalueequalsthis="true"
        id="BirthDate" name="BirthDate" value="" maxlength="10">
      <label for="BirthDate" class="active">Guarantor's Date of Birth</label>
    </div>
  </div>
  <input type="hidden" data-val="true" data-val-required="The Identity_Ssn4 field is required." id="Identity_Ssn4" name="Identity_Ssn4" value="False">
  <input type="hidden" data-val="true" data-val-required="The Identity_BirthDate field is required." id="Identity_BirthDate" name="Identity_BirthDate" value="True">
  <input type="hidden" data-val="true" data-val-required="The Identity_Zip field is required." id="Identity_Zip" name="Identity_Zip" value="False">
  <div style="clear:both;"></div>
  <input id="c6741d9a-938d-4d2d-9780-3385168b7d48" type="hidden" name="TimeZone" value="UTC">
  <input id="13591fb4-49e2-4d3f-ad6b-a44e48ec4da8" type="hidden" name="PrivateAccessCode" value="">
  <input id="59fd8949-1d3b-48e2-89d1-e3db010ceada" type="hidden" name="ReturnUrl" value="/">
  <input id="9418bff7-0f81-4f59-b14a-449c1cc888f3" type="hidden" name="OpcNotificationEmailId" value="">
  <input id="0f6de594-ba02-425b-b76f-e19f0d3e8637" type="hidden" name="Token" value="">
  <input id="72041cb6-0f4f-40b6-956d-124b654eba22" type="hidden" class="recaptcha-token" name="ReCaptchaToken" value="">
  <div class="validation-summary" style="display:none;">
    <div class="validation-summary-content"></div>
  </div>
  <div style="display:flex; flex-direction:row;">
    <a style="margin:0 0 0 4px; text-transform:initial; font-weight:300;" target="_blank" href="https://content.ci.healthpay24.cloud/df3715ca-0f7c-48f9-4d3f-08d8c6d7e667/PSH%20Statement%20Images%20Patient%20Portal%20Help%20Link%202021%2011%7C73676386-8d9f-41a6-bc5e-9a62d58a5b12.pdf" class="primary">Need help logging in?</a>
    <div style="flex-grow:1;"></div>
    <button type="submit" class="btn-login btn primary-accent-background">Access</button>
  </div>
  <input name="__RequestVerificationToken" type="hidden" value="CfDJ8CjjzZSwvwBEsKQj07THxDn5UcOH2BzVLobArF4IIK19jB-y4X-N7V-c3h8t-LZhWvrtnVNLDE0hakYz_g7M0s-xZqFqouR_DSzKmQslX30gMJbeWvHvsXNDR2o-mLIgHFYmr1kLfTVrTj_3GzFvvs8">
</form>

POST /account/emaillogin/

<form class="recaptcha-form" method="post" autocomplete="off" action="/account/emaillogin/" novalidate="novalidate">
  <div class="card-header">
    <div class="card-title">
      <div class="title">Account Login</div>
    </div>
    <div style="flex-grow:2;"></div>
  </div>
  <div class="form-group">
    <div class="input-field col s12">
      <input type="text" data-val="true" data-val-email="The field Email is invalid." data-val-length="This field cannot be more than 250 characters long." data-val-length-max="250" data-val-required=" " id="Email" maxlength="250" name="Email"
        value="">
      <label for="Email">Email</label>
    </div>
  </div>
  <div class="form-group">
    <div class="input-field col s12">
      <input type="password" data-val="true" data-val-length="The field Password must be a string with a maximum length of 50." data-val-length-max="50" data-val-required=" " id="Password" maxlength="50" name="Password">
      <label for="Password">Password</label>
      <a tabindex="4" class="helper-text primary" style="outline:0!important;" href="/account/forgotpassword/">Forgot your password?</a>
    </div>
  </div>
  <div style="clear:both;"></div>
  <input id="9a396560-6674-4c1c-b644-8c0526d5a3b2" type="hidden" name="TimeZone" value="UTC">
  <input id="9515e78c-65eb-4f02-a4fc-f74be12751c9" type="hidden" name="PrivateAccessCode" value="">
  <input id="ec8a09e6-f413-4492-8f28-1c0e226430cc" type="hidden" name="ReturnUrl" value="/">
  <input id="f6e9a709-9645-4b94-9258-e8388d03527e" type="hidden" name="OpcNotificationEmailId" value="">
  <input id="0e69dc73-37b2-410d-84b0-de5c4f9df77d" type="hidden" name="Token" value="">
  <input id="0191515b-e3f8-4ec6-bd78-341b87157506" type="hidden" class="recaptcha-token" name="ReCaptchaToken" value="">
  <div class="validation-summary" style="display:none;">
    <div class="validation-summary-content"></div>
  </div>
  <div style="display:flex; flex-direction:row;">
    <a class="btn-flat btn-outline primary" href="/account/createfamily/">CREATE ACCOUNT</a>
    <div style="flex-grow:1;"></div>
    <button type="submit" class="btn-login btn primary-accent-background right">LOG IN</button>
  </div>
  <input name="__RequestVerificationToken" type="hidden" value="CfDJ8CjjzZSwvwBEsKQj07THxDn5UcOH2BzVLobArF4IIK19jB-y4X-N7V-c3h8t-LZhWvrtnVNLDE0hakYz_g7M0s-xZqFqouR_DSzKmQslX30gMJbeWvHvsXNDR2o-mLIgHFYmr1kLfTVrTj_3GzFvvs8">
</form>

Text Content

Contact Us Patient Services

Welcome to our new Patient Payment Portal. As of March 1, 2022, we have upgraded
our system to provide a better experience for our patients. Thank you for your
continued support of Penn State Health.
Quick Pay

Encounter # / Receivable Group ID or Statement / Bill Number
Guarantor's Last Name
Guarantor's Date of Birth


Need help logging in?

Access
Account Login

Email
Password Forgot your password?


CREATE ACCOUNT

LOG IN

If you have a billing inquiry or concern about a refund, please contact customer
service at 1-800-254-2619.





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