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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

SEQUOIA HOSPITAL

170 ALAMEDA DE LAS PULGAS
REDWOOD CITY, CA 94062
http://www.sequoiahospital.org

License:

General Acute Care Hospital
Total Beds: 208
Emergency Room: Yes
more... Link to Atlas

Contact:

Business Office
(866) 240-2087

OSHPD ID:

106410891

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2006

Download:

Policy File

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

1/1/2006

Discount Payments

Discount Payment 1

FPL Range: 201%-350%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance

Discount Payment 2

FPL Range: 351%-500%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: 135% of average gov't rates above

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

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.

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