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Hospital Details

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SAN GORGONIO MEMORIAL HOSPITAL
600 N. HIGHLAND SPRINGS AVENUE
BANNING, CA  92220
http://www.sgmh.org/
General Acute Care Hospital
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Dan Heckathorne
(951) 769-2103
106331326
2/2/2022
200%
2/2/2022

Discount Payment 1

FPL Range: 201%-400%
Payment Basis:
Other: 25% of patient responsible portion of bill if paio

Discount Payment 2

FPL Range: 201%-400%
Payment Basis:
Other: If elective procedures 20% of billed charges total

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:
Uninsured obstetrical delivery: Fee Schedule effective January 1, 2022 Self- Pay Cash Price Plans for OB Delivery Patients Premium Delivery Plan: In order to take advantage of the premium discount plans for obstetrical and newborn inpatient services, patients will need to make payment either prior to admission or prior to discharge of the patient (s). • Plan 1 – Premium Delivery Plan for Normal Delivery Total payment will need to be made prior to discharge of mother and baby. The fee for delivery includes the charges for the newborn admission, if the newborn is discharged at the same time the mother is. If the newborn becomes a boarder baby, please refer to Plan 4 for Boarder Baby Hospitalization rate Normal / Vaginal Delivery – Length of Stay Fee for Delivery 1 Day $2,700 2 Days $4,800 3 Days $7,000 • Plan 2 – Premium Delivery Plan for Cesarean Section Total payment will need to be made prior to discharge of mother and baby. The fee for delivery includes the charges for the newborn admission, if the newborn is discharged at the same time the mother is. If the newborn becomes a boarder baby, please refer to Plan 4 for Boarder Baby Hospitalization rate Cesarean Delivery – Length of Stay Fee for Delivery 3 Days $7,000 4 days $9,000 • Plan 3 – Premium OB Non-Delivery Hospitalization Plan This applies to any OB related hospitalization not resulting in Delivery. Total payment will need to be made prior to discharge of patient. 1 Day $2,400 2 Days $3,000 3 Days $3,600 • Plan 4 – Premium Boarder Baby Hospitalization Plan This applies to any boarder baby hospitalization, where mother has been discharged and the baby either stays or is admitted during the first 30 days after birth. Total payment will need to be made prior to discharge of patient. Per Day Rate $500.00 Basic Delivery Plan: For patients unable to make payment in full prior to or at the time of delivery or hospitalization for an OB related service: The Basic Delivery Plan will be based at an 80% discount off the total charges incurred during the inpatient obstetrical services. In order to take advantage of the Basic discount plan for obstetrical and newborn inpatient services, patients will need to make a minimum deposit of $2,400 for a Normal Delivery, and $3,500 for a Cesarean Delivery. Note: Deposits for Boarder Baby hospitalization will be $250 per day Deposits for Non-Delivery OB Hospitalizations will be $1,200 per day. Payment arrangements for the remaining balances listed above will be established at the normal hospital payment plan policy and must be made within 30 days after discharge.
1/30/2008
Salary Received
Interest Received
Pension Received
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