HCAI Syfphr

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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

FOUNTAIN VALLEY REGIONAL HOSPITAL & MEDICAL CENTER - EUCLID

17100 EUCLID STREET
FOUNTAIN VALLEY, CA 92708
http://www.fountainvalleyhospital.com

License:

General Acute Care Hospital
Total Beds: 293
Emergency Room: Yes
more... Link to Atlas

Contact:

Customer Care Unit
(888) 233-7868

OSHPD ID:

106301175

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

6/17/2022

Download:

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

6/17/2022

Discount Payments

FPL Range: 201%-350%
Payment Basis:
Medi-Cal

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

6/17/2022

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English
Spanish

Additional Information

Submit Charity Care Application to: Conifer Client Services P.O. Box 223849 Dallas, Texas 75222-3849

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