HCAI Syfphr

Search > Results > Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

BANNER LASSEN MEDICAL CENTER

1800 SPRING RIDGE DRIVE
SUSANVILLE, CA 96130
http://www.BannerHealth.com

License:

General Acute Care Hospital
Total Beds: 25
Emergency Room: Yes
more... Link to Atlas

Contact:

Diane Newell
(866) 640-3600 Ext. 2

OSHPD ID:

106184008

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2015

Download:

Federal Poverty Level for Free Care:

100%

Discount Payment Effective Date:

1/1/2015

Discount Payments

FPL Range: 100%-400%
Payment Basis:
Medicare
Other: 50% of the billed rate

FPL Range: 100%-200%
Payment Basis:
Other: EFA.

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

1/1/2015

Download:

Income Type Used:

Salary Received
Other: income tax return

Language Information

Available Languages:

English
Spanish

Additional Information

Banner Lassen Medical Center has one policy for both charity and discounts for the uninsured.

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