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Hospital Details
Policy Effective Date (Date Posted):
Most Recent (5/5/2015)
Download:
Policy File
Download:
Application File
General Information
Hospital:
SOUTHERN INYO HOSPITAL
501 EAST LOCUST STREET
LONE PINE
,
CA
93545
http://www.sihd.org
License:
General Acute Care Hospital
Total Beds:
37
Emergency Room:
Yes
more...
Contact:
Lee Barron
(760) 876-5501
OSHPD ID:
106141338
Fair Pricing Policy Information
Show FPL Chart
Policy Effective Date:
1/1/2005
Download:
Policy File
Federal Poverty Level for Free Care:
100
%
Discount Payment Effective Date:
1/1/2005
Discount Payments:
Discount Payment
1
FPL Range:
101
%-
150
%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: No insurance or low income with commercial ins 75%
Discount Payment
2
FPL Range:
151
%-
200
%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: No insurance or low income with commercial ins 50%
Discount Payment
3
FPL Range:
201
%-
250
%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: No insurance or low income with commerical ins 25%
Other Discount Payment Information:
Schedule indicating the level of discount in relation to total familial income is located with the application form.
Application Form Information
Application Form Eff Date:
1/1/2005
Download:
Application File
Income Type Used:
Salary Received
Interest Received
Pension Received
Other: child/spousal support, real estate, unemployment
Language Information
Available Languages:
English
Spanish
Additional Information
please send all mail to the PO Box, we receive NO mail at the street address. If sent to the street address it will be returned.
This page was last updated on Wednesday, October 26, 2016.