HCAI Syfphr

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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

PLUMAS DISTRICT HOSPITAL

1065 BUCKS LAKE ROAD
QUINCY, CA 95971
http://www.pdh.org

License:

General Acute Care Hospital
Total Beds: 16
Emergency Room: Yes
more... Link to Atlas

Contact:

Krista McComb
(530) 283-7908

OSHPD ID:

106320986

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2015

Download:

Federal Poverty Level for Free Care:

150%

Discount Payment Effective Date:

1/1/2015

Discount Payments

FPL Range: 151%-190%
Payment Basis:
Other: 75% Discount

FPL Range: 191%-220%
Payment Basis:
Other: 50% Discount

FPL Range: 221%-250%
Payment Basis:
Other: 25% Discount

Other Discount Payment Information:

All other charity care will be determined on a case-by-case basis.

Application Form Information

Application Form Eff Date:

9/8/2003

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English

Additional Information

Our Charity Care and Discount Payment Plan are combined into one policy and procedure.

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