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Details
Hospital Details
Policy Effective Date (Date Posted):
Most Recent (6/11/2012)
General Information
Hospital:
SANTA CLARA VALLEY MEDICAL CENTER
751 SOUTH BASCOM AVENUE
SAN JOSE
,
CA
95128-2699
http://www.scvmed.org
License:
General Acute Care Hospital
Total Beds:
574
Emergency Room:
Yes
more...
Contact:
Pt Bus Svs Customer Service Unit
(408) 885-7470
OSHPD ID:
106430883
Fair Pricing Policy Information
Click for FPL Chart
Policy Effective Date:
1/1/2007
Download:
Policy File
Federal Poverty Level for Free Care:
100
%
Discount Payment Effective Date:
1/1/2007
Discount Payment
1
Federal Poverty Level Range:
101
%-
350
%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
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:
Application Form Information
Application Form Eff Date:
1/1/2007
Download:
Application File
Income Type Used:
Salary Received
Interest Received
Pension Received
Other: all forms of income
Language Information
Available Languages:
English
Spanish
Vietnamese
Additional Information
Our Charity Care program is limited to emergency care only and the patient's familial income must be at or below 100% of the FPL. Because of this we have an overlap in the FPL level between our Charity Care & Discount Payment program. Those patients that are not able to qualify for charity care may be qualified for discounted payments (see hospital's charity care and discounted payment policies for more information). We also take applications using 2 methods, i.e. on-line and hard copy. Only the hard copy application is in the multiple languages indicated.
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.
