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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

EASTERN PLUMAS HOSPITAL-PORTOLA CAMPUS

500 1ST AVE
PORTOLA, CA 96122
http://www.ephc.org

License:

General Acute Care Hospital
Total Beds: 36
Emergency Room: Yes
more... Link to Atlas

Contact:

TIFFANY WILLIAMS
(530) 832-6564

OSHPD ID:

106320859

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

12/31/2014

Download:

Policy File

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

12/31/2014

Discount Payments

Discount Payment 1

FPL Range: 200%-300%
Payment Basis:
Other: COST SHARE SCALE

Discount Payment 2

FPL Range: 0%-0%
Payment Basis:

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

12/31/2014

Download:

Application File

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: Tax Return Income; Bank Statements

Language Information

Available Languages:

English
Spanish

Additional Information

Determination of free care for patients is based upon a calculation performed by hospital management where the patient's familial income being at or below 200% of the FPL is part of the calculation.

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