Financial Assistance

Financial Assistance | Charity Care

Chinese Hospital has a variety of financial assistance options available to our patients who are uninsured or underinsured. We will assist you in determining if you qualify for financial assistance or if there are programs available that may help pay for your medical services. If you are not able to pay your bill, please read this important information on the options available to you.

VIEW FINANCIAL ASSISTANCE POLICY AND CHARITY CARE POLICY
(The FAP, FAP application form and plain language summary of the FAP are available in English, Chinese and Spanish. To translate the documents in any other languages, contact Patient Financial Services Department.)

FINANCIAL ASSISTANCE POLICY (FAP)

English

Chinese / 中文

Spanish / Español

CHARITY CARE POLICY

English

Chinese / 中文

Spanish / Español

DOWNLOAD FINANCIAL ASSISTANCE AND CHARITY CARE APPLICATIONS FORMS

HOW TO APPLY / RECEIVE A COPY

To receive a free copy of the FAP and FAP application form by mail, please contact our Patient Financial Services Department. A representative will obtain your mailing address and mail the application form to you.

For assistance with applying for FAP, a representative from Patient Financial Services will help you with the form. A completed application can be mailed to Patient Financial Services, 845 Jackson St, San Francisco, CA 94133. 

We can also assist with your application and provide the applications for Medicare, Healthy Families Program, Medi-Cal, or other coverage offered through the California Health Benefit Exchange, California Children’s Services program, other state- or county-funded health coverage. If you lack, or have inadequate, insurance, and you meet low- and moderate-income requirements, you may qualify for discounted payment or charity care. Please contact us for more information.

Patient Financial Services Department
Phone: 1-415-677-2314
Office: 845 Jackson St, 4th Floor, San Francisco, CA 94133
Hours: Monday to Friday, 8:00 a.m. - 4:30 p.m.

FAP application form is also available at all of our clinic locations, CCHRC Library, and CCHP Sales Department. .

VIEW FINANCIAL ASSISTANCE PLAIN LANGUAGE SUMMARY

VIEW CHARITY CARE ASSISTANCE NOTIFICATION

ELIGIBLE SERVICES

Professional fees that are not billed by Chinese Hospital will not be covered under this Financial Assistance Policy, except as may be provided for under other policies or contracts.  Professional fees not billed by Chinese Hospital include:

LIST OF CHINESE HOSPITAL PROVIDERS

Please click here to view the list.

QUESTIONS

Additional information and/or a statement of charges for services rendered by the hospital may be obtained by calling Patient Financial Services Department at 1-415-677-2314 or visit us at our office located at 845 Jackson St, 4th Floor, San Francisco, CA 94133, we are available Monday to Friday, 8:00 a.m. - 4:30 p.m.