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Hospital Details
Policy Effective Date (Date Posted):
2022-2023 (Most Recent)
2022-2023 (11/18/2022)
2020-2021 (2/17/2021)
2020-2021 (12/29/2020)
2018-2019 (12/28/2017)
2016-2017 (1/6/2017)
2014-2015 (12/30/2014)
Go
Download:
Policy File
Download:
Application File
General Information
Hospital:
LOMA LINDA UNIVERSITY CHILDREN'S HOSPITAL
11234 ANDERSON ST.
LOMA LINDA, CA 92354
http://www.lomalindahealth.org
License:
General Acute Care Hospital
View License Information...
Contact:
Public Relations
(909) 558-4419
OSHPD ID:
106364502
Fair Pricing Policy Information
Show FPL Chart
Policy Effective Date:
12/1/2022
Download:
Policy File
Federal Poverty Level for Free Care:
200%
Discount Payment Effective Date:
12/1/2022
Discount Payments
Discount Payment
1
FPL Range:
201
%-
250
%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 75% of Medicare Allowable
Discount Payment
2
FPL Range:
251
%-
300
%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 50% of Medicare Allowable
Discount Payment
3
FPL Range:
301
%-
350
%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 25% of Medicare Allowable
Other Discount Payment Information:
Discount Payment 4: FPL minimum 351% FPL maximum 400% 15% of Medicare allowable
Application Form Information
Application Form Eff Date:
12/24/2014
Download:
Application File
Income Type Used:
Salary Received
Language Information
Available Languages:
English
Spanish
Additional Information
Family
Size
100%
150%
200%
250%
300%
350%
400%