{"hospital":{"ccn":"050103","name":"ADVENTIST HEALTH WHITE MEMORIAL","city":"LOS ANGELES","state":"CA","zip":"90033","phone":"323-268-5000","ownership":"Voluntary non-profit - Church","website_domain":"adventisthealth.org","system":null},"version":5,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"Adventist Health shall provide charity care (zero patient responsibility) for Self-Pay Patients at or below 200% or less of the Federal Poverty Level.","source_id":"application-9144604435c57343","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"discount_tiers":null,"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Financial Assistance may be applied to uninsured patients, as well as the patient liability for patients with insurance, including charges determined uninsured for the hospital stay, coinsurance, copayment, deductible amounts and other liabilities for medically necessary hospital services except for Medicaid SOC","source_id":"application-9144604435c57343","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":{"value":["Medicaid"],"layer":"documented","quote":"Adventist Health will apply a presumptive Charity Care determination of 100% assistance in the following situations: i. Patient has an active Medicaid plan.","source_id":"fap-83ffdddfd7847c4f","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["pay_stubs"],"layer":"documented","quote":"Provide a copy of patient’s or guarantor’s most recent pay stub (or certify that he or she is currently unemployed);","source_id":"application-9144604435c57343","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":null,"window_days_from_first_bill":{"value":240,"layer":"documented","quote":"Application Period – The period during which Adventist Health must accept and process an application for financial assistance under its Financial Assistance Policy submitted by an individual in order to have made reasonable efforts to determine whether the individual is eligible for financial assistance under the policy. The Application Period begins on the date the care is provided and ends on the latter of the 240th day after the date that the first post-discharge billing statement for the care is provided or at least 30 days after Adventist Health provides the individual with a written notice that sets a deadline after which ECAs may be initiated.","source_id":"application-9144604435c57343","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":null,"collection_agencies":null},"contacts":{"phone":{"value":"1-844-827-5047","layer":"documented","quote":"Calling us at 1-844-827-5047 (or local hospital – See appendix B of this policy)","source_id":"application-9144604435c57343","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"hours":null,"languages":null},"coverage":{"facilities":{"value":["Adventist Health White Memorial"],"layer":"documented","quote":"Adventist Health White Memorial 1720 East Cesar E. Chavez Ave.\nLos Angeles, CA 90033 323-268-5000","source_id":"application-9144604435c57343","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"provider_list_url":null},"sources":[{"id":"application-9144604435c57343","kind":"hospital_web","url":"https://www.adventisthealth.org/documents/system/financial-assistance-policy-and-application.pdf","title":"[PDF] FINANCIAL ASSISTANCE POLICY - Adventist Health","fetched_on":"2026-10-09","sha256":"9144604435c57343de648406e5367fdfbd2b1258a6a66924733483633c1f94b6","effective_date":null},{"id":"fap-83ffdddfd7847c4f","kind":"hospital_web","url":"https://www.adventisthealth.org/documents/system/financial-assistance-policy-california.pdf","title":"[PDF] Financial Assistance Policy for California-Based Hospitals","fetched_on":"2026-10-09","sha256":"83ffdddfd7847c4f8b5ffc77d2b1f02e4126b215f0a329902a320eea40a4265c","effective_date":null}],"accuracy":null}