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Hospital Details
Policy Effective Date (Date Posted):
2022-2023 (Most Recent)
2022-2023 (12/8/2022)
2014-2015 (5/5/2015)
2012-2013 (6/1/2012)
2012-2013 (6/1/2012)
2010-2011 (5/19/2010)
2010-2011 (5/19/2010)
2008-2009 (6/12/2008)
2008-2009 (6/12/2008)
Go
Download:
Policy File
Download:
Application File
General Information
Hospital:
COLLEGE HOSPITAL COSTA MESA
301 VICTORIA STREET
COSTA MESA, CA 92627
https://chc.la/ch-costa-mesa
License:
General Acute Care Hospital
Total Beds:
122
Emergency Room:
Yes
more...
Contact:
Patient Account Department
(562) 904-3998
OSHPD ID:
106301155
Fair Pricing Policy Information
Show FPL Chart
Policy Effective Date:
3/1/2022
Download:
Policy File
Federal Poverty Level for Free Care:
400%
Discount Payment Effective Date:
3/1/2022
Discount Payments
Discount Payment
1
FPL Range:
401
%-
425
%
Payment Basis:
Medicare
Medi-Cal
Other: Hospital bill is discounted by 80%.
Discount Payment
2
FPL Range:
426
%-
450
%
Payment Basis:
Other: Hospital bill is discounted by 60%.
Discount Payment
3
FPL Range:
0
%-
0
%
Payment Basis:
Other Discount Payment Information:
Application Form Information
Application Form Eff Date:
12/1/2006
Download:
Application File
Income Type Used:
Salary Received
Language Information
Available Languages:
English
Additional Information
Family
Size
100%
150%
200%
250%
300%
350%
400%
