SOUTHERN INYO HOSPITAL

SOUTHERN INYO HOSPITAL
501 EAST LOCUST STREET
LONE PINE, CA  93545
http://www.sihd.com

Contact:

Lee Barron
(760) 876-5501

License:

General Acute Care Hospital
Total Beds:  37
Emergency Room:  Yes

OSHPD ID:

106141338

Fair Pricing Policy Information  

Policy Effective Date:1/1/2005

Download:

Policy File

PDF Document Icon

Federal Poverty Level for Free Care:

100%

Discount Payment Effective Date:1/1/2005

Discount Payments:

Discount Payment 1

FPL Range: 101%-150%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: No insurance or low income with commercial ins 75%

Discount Payment 2

FPL Range: 151%-200%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: No insurance or low income with commercial ins 50%

Discount Payment 3

FPL Range: 201%-250%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance
Other: No insurance or low income with commerical ins 25%

Other Discount Payment Information:

Schedule indicating the level of discount in relation to total familial income is located with the application form.

Application Form Information

Application Form Eff Date:1/1/2005

Download:

Application File

PDF Document Icon

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: child/spousal support, real estate, unemployment

Language Information

Available Languages:

English
Spanish

Additional Information

please send all mail to the PO Box, we receive NO mail at the street address. If sent to the street address it will be returned.

Source” :https://syfphr.oshpd.ca.gov/SearchDetail.aspx?oshpdid=106141338

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