HCAI Syfphr

Search > Results > Details

Policy Effective Date (Date Posted):

Download: Policy File

Download: Application File

General Information

Hospital:

SAN JOSE BEHAVIORAL HEALTH

455 SILICON VALLEY BOULEVARD
SAN JOSE, CA 95138
https://www.sanjosebh.com/?utm_source=GMB&utm_medi

License:

Acute Psychiatric Hospital
Total Beds: 80
Emergency Room: Yes
more... Link to Atlas

Contact:

Rachel Cox
(669) 234-5959

OSHPD ID:

106434032

Fair Pricing Policy Information Show FPL Chart

Policy Effective Date:

6/4/2020

Download:

Federal Poverty Level for Free Care:

133%

Discount Payment Effective Date:

12/1/2022

Discount Payments

FPL Range: 133%-400%
Payment Basis:
Other: Ability to pay based on required documents

FPL Range: 0%-0%
Payment Basis:

FPL Range: 0%-0%
Payment Basis:

Other Discount Payment Information:

Application Form Information

Application Form Eff Date:

12/8/2022

Download:

Income Type Used:

Salary Received
Interest Received
Pension Received
Other: please see attached Financial Assistance Policy

Language Information

Available Languages:

English
Other: interpreters are available if needed

Additional Information

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