{"hospital":{"ccn":"050336","name":"ADVENTIST HEALTH LODI MEMORIAL","city":"LODI","state":"CA","zip":"95240","phone":"209-334-3411","ownership":"Voluntary non-profit - Other","website_domain":"adventisthealth.org","system":null},"version":3,"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:\ni. Patient has an active Medicaid plan.\nii. Patient is eligible for Medicaid; or\niii. Patients with current active Medicaid coverage, even if they did not have Medicaid coverage on the date of service","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 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":"209-334-3411","layer":"documented","quote":"Adventist Health Lodi Memorial 975 S. Fairmont Avenue Lodi, CA 95240 209-334-3411","source_id":"application-9144604435c57343","checked_on":"2026-10-09","confidence":1.0,"support_count":0},"hours":null,"languages":null},"coverage":{"facilities":{"value":["Adventist Health Lodi Memorial"],"layer":"documented","quote":"Adventist Health Lodi Memorial 975 S. Fairmont Avenue Lodi, CA 95240 209-334-3411","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}