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Details
Hospital Details
Policy Effective Date (Date Posted):
Most Recent (6/4/2012)
General Information
Hospital:
FRANK R HOWARD MEMORIAL HOSPITAL
1 MADRONE STREET
WILLITS
,
CA
95490
http://www.howardhospital.com
License:
General Acute Care Hospital
Total Beds:
38
Emergency Room:
Yes
more...
Contact:
Christine Weberski
(707) 456-3014
OSHPD ID:
106230949
Fair Pricing Policy Information
Click for FPL Chart
Policy Effective Date:
1/1/2007
Download:
Policy File
Federal Poverty Level for Free Care:
200
%
Discount Payment Effective Date:
1/1/2007
Other Charity Care Discount Payment Information:
Application Form Information
Application Form Eff Date:
1/1/2007
Download:
Application File
Income Type Used:
Salary Received
Interest Received
Pension Received
Language Information
Available Languages:
English
Other: Application only also available in Spanish
Additional Information
Emergency Services - Income of 0% to 200% of the federal poverty level (FPL) equals zero patient liability. Income of 201% of the FPL to 300% of the FPL equals patient liability of 50% of what Medicare would allow for the same service. Income of 301% of the FPL to 400% of the FPL equals patient liability of 75% of the Medicare allowed amount. Income of greater than 400% of the Federal Poverty Level equals the self pay liability amount. Non Emergency Services - Income of 0% to 200% of the FPL equals patient liability of 50% of what Medicare would allow. Income of 201% of the FPL to 350% of the FPL equals patient liability of 100% of what Medicare would allow. Income of 351% of the FPL to 400% of the FPL equals patient liability of 75% of the facility's self pay liability amount. Greater than 400% of the FPL equals 100% of the patient liability amount. Adventist Health facilities may be more lenient (lower patient liability) but they may not be less lenient (higher patient liability).
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.
