HCAI Syfphr

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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

FRESNO SURGICAL HOSPITAL

6125 NORTH FRESNO STREET
FRESNO, CA 93710
http://www.fresnosurgicalhospital.com

License:

General Acute Care Hospital
Total Beds: 27
Emergency Room: Yes
more... Link to Atlas

Contact:

Patient Accounting
(559) 431-8000

OSHPD ID:

106104047

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/18/2021

Download:

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

1/18/2021

Discount Payments

FPL Range: 201%-400%
Payment Basis:
Medicare
Other: 60% discount of charges

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

1/18/2021

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: Annual Federal Reporting

Language Information

Available Languages:

English
Spanish

Additional Information

Revised policy to reflect changes imposed through SB 1276. Revised policy effective 01/18/2021

Family Size	100%	150%	200%	250%	300%	350%	400%