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Hospital Details

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POMONA, CA  91767
General Acute Care Hospital
Total Beds:  99
Emergency Room:  Yes
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Stephanie Bradhurst
(909) 596-7733 x2227

Discount Payment 1

FPL Range: 201%-250%
Payment Basis:
Other: Patient is responsible for 25% of total bill.

Discount Payment 2

FPL Range: 251%-300%
Payment Basis:
Other: Patient is responsible for 50% of total bill.

Discount Payment 3

FPL Range: 301%-400%
Payment Basis:
Other: Patient is responsible for 75% of total bill.
Casa Colina deems those patients that are eligible for any or all government sponsored low-income assistance programs to be indigent. Therefore ,such patients are automatically eligible for Charity Care under the Casa Colina Policy and account balances will be classified as Charity Care if the government program does not make payment for all services provided, or days during a hospital stay. For example, patients who qualify for Medi-Cal, CCS, CHDP, MSI, CMSP, or other similar low-income government programs are eligible for financial assistance. Any or all non-reimbursed patient account balances are eligible for full write-off as Charity Care. Specifically included as Charity Care are charges related to denied stays, denied days of care, and non-covered services. All Treatment Authorization Request (TAR) denials and any other failure to pay for covered or non-covered services provided to MediCal and/or other government low-income qualified patients are covered. Patients with restricted coverage and/or other forms of limitation shall have non-covered amounts classified as Charity Care when payment is not made by the low-income government program. The portion of Medicare patient accounts(a) for which the patient is financially responsible (coinsurance and deductible amounts), (b) which is not covered by insurance or any other payer including Medi-Cal, and (c) which is not reimbursed by Medicare as a bad debt, may be classified as Charity Care if: 1. The patient is a beneficiary under Medi-Cal or another program serving the healthcare needs of low-income patients; or 2. The patient otherwise qualifies for financial assistance under this policy and then only to the extent of the write off provided for under this policy. Any patient who experiences a catastrophic medical event may be deemed eligible for financial assistance. The determination of a catastrophic medical event shall be based upon the amount of the patient liability at billed charges, and consideration of the individual’s income and assets as reported at the time of occurrence. Management shall use reasonable discretion in making a determination based upon a catastrophic medical event. As a general guideline, any account with a patient liability for services rendered that exceeds $100,000 may be considered for eligibility as a catastrophic medical event. Any account returned to the hospital from a collection agency, where it has been determined the patient or guarantor does not have the resources to pay their bill, may be deemed eligible for Charity Care. Documentation of the patient or guarantor’s inability to pay for services will be maintained in the Charity Care documentation file.
Salary Received
Interest Received
Pension Received