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Hospital Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

UCSF MEDICAL CENTER AT MOUNT ZION

1600 DIVISADERO STREET
SAN FRANCISCO, CA 94115
http://www.ucsfhealth.org

License:

General Acute Care Hospital
Total Beds: 140
Emergency Room: Yes
more... Link to Atlas

Contact:

Financial Counseling Dept.
(415) 353-1966

OSHPD ID:

106380895

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

1/1/2016

Download:

Policy File

Federal Poverty Level for Free Care:

200%

Discount Payment Effective Date:

1/1/2016

Discount Payments

Discount Payment 1

FPL Range: 201%-400%
Payment Basis:
Medicare
Medi-Cal
Healthy Families
Other Government Insurance

Discount Payment 2

FPL Range: 0%-0%
Payment Basis:

Discount Payment 3

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Regardless of income, patients with no third party coverage are given a self-pay discount comparable to Medicare DRG rates for inpatient services and Medicare APC rates for outpatient services. Please refer to the Patient Financial Assistance Policy.

Application Form Information

Application Form Eff Date:

7/1/2016

Download:

Application File

Income Type Used:

Salary Received
Interest Received
Pension Received

Language Information

Available Languages:

English
Spanish
Chinese
Russian

Additional Information

Policy updated.

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