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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

LOS ANGELES COUNTY OLIVE VIEW-UCLA MEDICAL CENTER

14445 OLIVE VIEW DRIVE
SYLMAR, CA 91342
http://www.ladhs.org

License:

General Acute Care Hospital
Total Beds: 355
Emergency Room: Yes
more... Link to Atlas

Contact:

Sofia Hurtado
(213) 240-8277

OSHPD ID:

106191231

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

12/15/2007

Download:

Policy File

Federal Poverty Level for Free Care:

138%

Discount Payment Effective Date:

12/15/2007

Discount Payments

Discount Payment 1

FPL Range: 138%-400%
Payment Basis:
Medi-Cal

Discount Payment 2

FPL Range: 0%-0%
Payment Basis:

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

The Hospital's discount policy does not establish a strict FPL based limit on eligibility; rather, patient liability is a function of the patient's ability to pay, and the size of his or her liability for services. Only patients whose income is at or below 400% of FPL are entitled to have their charges limited to what Medi-Cal would pay.

Application Form Information

Application Form Eff Date:

1/1/2008

Download:

Application File

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English
Spanish

Additional Information

The attached policy was converted using Adobe OCR and may have some typographical errors or graphical inconsistencies due to poor character recognition. Please refer to the original policies if you have questions regarding these policies.

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