HCAI Syfphr

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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

GARDEN GROVE HOSPITAL AND MEDICAL CENTER

12601 GARDEN GROVE BLVD.
GARDEN GROVE, CA 92843-1908
http://www.gardengrovehospital.com

License:

General Acute Care Hospital
Total Beds: 167
Emergency Room: Yes
more... Link to Atlas

Contact:

Toni Relerford
(714) 741-2712

OSHPD ID:

106301283

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

12/1/2021

Download:

Federal Poverty Level for Free Care:

400%

Discount Payment Effective Date:

12/1/2021

Discount Payments

FPL Range: 401%-450%
Payment Basis:
Medicare
Medi-Cal

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

FPL Criteria for Charity Care 400%

Application Form Information

Application Form Eff Date:

12/1/2021

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English
Spanish

Additional Information

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