HCAI Syfphr

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Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

HOAG ORTHOPEDIC INSTITUTE

16250 SAND CANYON AVENUE
IRVINE, CA 92618
https://www.hoag.org

License:

General Acute Care Hospital
Total Beds: 70
Emergency Room: Yes
more... Link to Atlas

Contact:

Kathleen Graham
(949) 764-4624

OSHPD ID:

106304460

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

5/8/2018

Download:

Federal Poverty Level for Free Care:

Discount Payment Effective Date:

5/8/2018

Discount Payments

FPL Range: 201%-400%
Payment Basis:
Medicare

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Self Pay Patients who are >400%FPL automatically qualify for 35% discount

Application Form Information

Application Form Eff Date:

5/8/2018

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: tax return

Language Information

Available Languages:

English
Spanish
Vietnamese
Korean
Chinese
Other: Arabic and Farsi

Additional Information

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