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Hospital Details

Policy Effective Date (Date Posted):

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... Link to Atlas

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.

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