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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

CHILDREN'S HOSPITAL OF LOS ANGELES

4650 W. SUNSET BOULEVARD
LOS ANGELES, CA 90027
http://www.childrenshospitalla.org

License:

General Acute Care Hospital
Total Beds: 495
Emergency Room: Yes
more... Link to Atlas

Contact:

Jeannie Garcia
(323) 361-3715

OSHPD ID:

106190170

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

10/25/2016

Download:

Policy File

Federal Poverty Level for Free Care:

400%

Discount Payment Effective Date:

10/25/2016

Discount Payments

Discount Payment 1

FPL Range: 401%-600%
Payment Basis:
Medicare
Other: AGB methodology using Medicare/PHI

Discount Payment 2

FPL Range: 0%-0%
Payment Basis:

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Patients with income between 101%-400% of FPL qualify for 100% charity care. Patients who fall between 401% and 600% of FPL qualify for a discount on a sliding scale.

Application Form Information

Application Form Eff Date:

4/25/2017

Download:

Application File

Income Type Used:

Salary Received

Language Information

Available Languages:

English
Spanish
Vietnamese
Korean
Chinese
Armenian
Other: Arabic

Additional Information

Some updates done to accommodate new requirements, additional updates in process for January 2023 deadline for 501r regs.

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