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Hospital Details

Policy Effective Date (Date Posted):

General Information

Hospital:

LAC/HARBOR-UCLA MEDICAL CENTER
1000 WEST CARSON STREET
TORRANCE, CA 90502
http://www.harbor-ucla.org/

License:

General Acute Care Hospital
Total Beds: 538
Emergency Room: Yes
more...

Contact:

MARY JOHNSON - Manager Eligibility & Provider Svcs
(213) 240-8277

OSHPD ID:

106191227

Fair Pricing Policy Information Click for FPL Chart

Policy Effective Date: 12/15/2007

Download: Policy File

Federal Poverty Level for Free Care: 133%

Discount Payment Effective Date: 12/15/2007

Discount Payment 1
Federal Poverty Level Range: 134%-350%
Payment Basis:
Medi-Cal
Discount Payment 2
Federal Poverty Level Range: 0%-0%
Payment Basis:

Discount Payment 3
Federal Poverty Level Range: 0%-0%
Payment Basis:

Other Charity Care Discount Payment Information:

The Hospital's discount policy does not establish a strict FPL based limit on eligibility; rather, patient liability is a function of the patient's ability to pay, and the size of his or her liability for services. Only patients whose income is at or below 350% of FPL are entitled to have their charges limited to what Medi-Cal would pay.

Application Form Information

Application Form Eff Date: 1/1/2008

Download: Application File

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English
Spanish

Additional Information

Note: To view downloaded .pdf files you will need to install the free Adobe Acrobat Reader. To download the program, please click the image below.

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