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Details
Hospital Details
Policy Effective Date (Date Posted):
Most Recent (6/6/2012)
1/1/2006 (5/20/2011)
General Information
Hospital:
WOODLAND MEMORIAL HOSPITAL
1325 COTTONWOOD STREET
WOODLAND
,
CA
95695
http://www.woodlandhealthcare.org
License:
General Acute Care Hospital
Total Beds:
108
Emergency Room:
Yes
more...
Contact:
Business Office
(530) 668-2600 Ext. 2
OSHPD ID:
106571086
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
Discount Payment
1
Federal Poverty Level Range:
201
%-
350
%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Discount Payment
2
Federal Poverty Level Range:
351
%-
500
%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: 135% of average gov't rates above
Discount Payment
3
Federal Poverty Level Range:
0
%-
0
%
Payment Basis:
Other Charity Care Discount Payment Information:
Patients whose income exceeds 500% of the FPL may be eligible to receive discounted rates on a case-by-case basis based on their specific circumstances, such as catastrophic illness or medical indigence, at the discretion of the CHW Facility.
Application Form Information
Application Form Eff Date:
5/31/2007
Download:
Application File
Income Type Used:
Salary Received
Interest Received
Other: Business or Rental Income
Language Information
Available Languages:
English
Spanish
Vietnamese
Korean
Chinese
Armenian
Russian
Other: Farsi and Khmer
Additional Information
The attached word document contains two policies: Patient Payment Assistance Policy and Eligibility & Application Policy and Procedures for Payment Assistance. The Patient Payment Assistance Policy outlines the discounts for both 100% Charity Care and other payment discounts. The Eligibility and Application policy contains the eligibility and review procedures.
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.