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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

PRISCILLA CHAN & MARK ZUCKERBERG SAN FRANCISCO GENERAL HOSPITAL & TRAUMA CE

1001 POTRERO AVENUE
SAN FRANCISCO, CA 94110
http://www.dph.sf.ca.us/chn/sfgh

License:

General Acute Care Hospital
Total Beds: 397
Emergency Room: Yes
more... Link to Atlas

Contact:

Patient Financial Services Department
(628) 206-3275

OSHPD ID:

106380939

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

8/3/2019

Download:

Policy File

Federal Poverty Level for Free Care:

138%

Discount Payment Effective Date:

8/3/2019

Discount Payments

Discount Payment 1

FPL Range: 139%-500%
Payment Basis:
Other: Charity Care and Discount Payment programs

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:

8/3/2019

Download:

Application File

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: Non-public assistance income.

Language Information

Available Languages:

English
Spanish
Vietnamese
Tagalog
Chinese
Russian

Additional Information

Charity patients 0-138% FPL are charged the following patient liability: Outpatient : No patient liability Outpatient ER: No patient liability Inpatient: No patient liability Come & Go: No patient liability

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