CASA COLINA HOSPITAL

CASA COLINA HOSPITAL
255 EAST BONITA AVENUE
POMONA, CA  91767
http://CasaColina.Org

Contact:

Lisa Sousamain
(909) 596-7733 Ext. 2166

License:

General Acute Care Hospital
Total Beds:  99
Emergency Room:  Yes

OSHPD ID:

106190137

Fair Pricing Policy Information  

Policy Effective Date:1/1/2016

Download:

Policy File

PDF Document Icon

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:1/1/2016

Discount Payments:

Discount Payment 1

FPL Range: 201%-250%
Payment Basis:
Other: Patient is responsible for 25% of total bill.

Discount Payment 2

FPL Range: 251%-300%
Payment Basis:
Other: Patient is responsible for 50% of total bill.

Discount Payment 3

FPL Range: 301%-350%
Payment Basis:
Other: Patient is responsible for 75% of total bill.


Other Discount Payment Information:

Application Form Information

Application Form Eff Date:1/1/2016

Download:

Application File

PDF Document Icon

Income Type Used:

Salary Received
Interest Received
Pension Received


Language Information

Available Languages:

English
Spanish


Additional Information

No significant changes since last update for 2015-2016 in accordance with SB1276 updates.

Source” : https://syfphr.oshpd.ca.gov/SearchDetail.aspx?oshpdid=106190137

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