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Policy Effective Date (Date Posted):

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
Total Beds: 343
Emergency Room: Yes
more... Link to Atlas

Contact:

Public Relations
(909) 558-4419

OSHPD ID:

106364502

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

12/1/2022

Download:

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

12/1/2022

Discount Payments

FPL Range: 201%-250%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 75% of Medicare Allowable

FPL Range: 251%-300%
Payment Basis:
Medicare
Medi-Cal
Worker's Compensation
Other Government Insurance
Other: 50% of Medicare Allowable

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:

Income Type Used:

Salary Received

Language Information

Available Languages:

English
Spanish

Additional Information

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