{"hospital":{"ccn":"051320","name":"BANNER LASSEN MEDICAL CENTER","city":"SUSANVILLE","state":"CA","zip":"96130","phone":"530-252-2000","ownership":"Voluntary non-profit - Private","website_domain":"bannerhealth.com","system":null},"version":1,"status":"published","eligibility":{"free_care_max_fpl":{"value":"200","layer":"documented","quote":"< 200% of FPL  100% discount off  AGB  100%  discount off BAI","source_id":"billing-05dda554b6e69114","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"discount_tiers":{"value":[{"min_fpl_exclusive":"200","max_fpl_inclusive":"300","discount_percent":75},{"min_fpl_exclusive":"300","max_fpl_inclusive":"400","discount_percent":50}],"layer":"documented","quote":"< 200% of FPL  100% discount off  AGB  100%  discount off BAI\n\n200%  - 300% FPL  75% discount off AGB  75% discount off BAI\n\n> 300%  - 400% FPL  50% discount off AGB  50% discount off BAI","source_id":"billing-05dda554b6e69114","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"asset_test":null,"residency":null,"insured_patients_covered":{"value":true,"layer":"documented","quote":"Underinsured Patients have insurance but face financial hardship due to high deductibles, co-pays, or co-insurance.","source_id":"application-79bac09f09235e36","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"min_balance":null,"services_excluded":null},"programs":{"presumptive":null,"state_programs":null},"apply":{"form_url":null,"form_version":null,"documents_required":{"value":["proof_of_income","tax_return","pay_stubs"],"layer":"documented","quote":"Proof of Income – required. Acceptable documents include:\n\n1.  If currently employed, copies of 3 most recent payroll stubs for Patient, Applicant (if not patient), and Spouse/Partner, if they occurred within a 6-month period before or after the patient was first billed by the Hospital.\n\n2.  If Self-employed or unemployed, a copy of income tax returns for the year in which the patient was first billed or 12 months prior to when the Patient was first billed by the Hospital.","source_id":"application-79bac09f09235e36","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"documents_reported":null,"submit_methods":{"value":[{"kind":"mail","detail":"Banner Health c/o PBM, PO Box 743711, Los Angeles, CA 90074-3711"},{"kind":"email","detail":"BannerFAAApplications@bannerhealth.com"}],"layer":"documented","quote":"Instructions - Please fill in all fields, attach the required documentation, and send to \n\nBanner Health c/o PBM, PO Box 743711, Los Angeles, CA 90074-3711 or BannerFAAApplications@bannerhealth.com","source_id":"application-79bac09f09235e36","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"window_days_from_first_bill":null,"decision_days":null,"decision_days_reported":null},"collections":{"eca_wait_days":{"value":180,"layer":"documented","quote":"BH , under BH ’s Patient Financial Services operating unit ’s\n\nauthority , may take any and all legal actions , including Extraordinary Collections Actions  \n\n(\" ECAs \"), to obtain payment for services provided where payment has not been made as of 180 days past the date of the first billing statement for those services (the \n\n\"Notification Period \").","source_id":"billing-05dda554b6e69114","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"collection_agencies":null},"contacts":{"phone":{"value":"(888) 264-2127","layer":"documented","quote":"You can also request copies by mail or get help by calling Banner Patient Financial Services at (888) 264-2127, where staff can assist with applications and connect you to additional resources.","source_id":"application-79bac09f09235e36","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"hours":{"value":"6:00 AM to 10:00 PM","layer":"documented","quote":"If you need help in another language, please call 888-264-2127 from 6:00 AM to 10:00 PM or visit the Banner Lassen Medical Center information desk located at 1800 Spring Ridge Drive, Susanville, CA 96130.","source_id":"application-79bac09f09235e36","checked_on":"2026-10-10","confidence":1.0,"support_count":0},"languages":{"value":["English","Spanish"],"layer":"documented","quote":"Free copies of Banner Health’s financial assistance, billing, and collections policies— as well as application forms —are available in Spanish and English at BannerHealth.com.","source_id":"application-79bac09f09235e36","checked_on":"2026-10-10","confidence":1.0,"support_count":0}},"coverage":{"facilities":null,"provider_list_url":null},"sources":[{"id":"application-79bac09f09235e36","kind":"hospital_web","url":"https://www.bannerhealth.com/-/media/files/project/bh/patients-visitors/billing/financial-assistance/2025-documents/99990269--financialassistanceapplication-11032025.ashx","title":"Banner Lassen Financial Assistance Program for Discount ...","fetched_on":"2026-10-10","sha256":"79bac09f09235e3607d162c01745f7410e2d0d81a904562aa1fe394b14c2dae7","effective_date":null},{"id":"summary-0f440e73c46fe1b3","kind":"hospital_web","url":"https://www.bannerhealth.com/patients/billing/financial-assistance/amounts-generally-billed-calculation-summary","title":"Plain Language Summary","fetched_on":"2026-10-10","sha256":"0f440e73c46fe1b3d793645d6a8ef7cfdbde1e9b643ef74591a1df610cc8257c","effective_date":null},{"id":"billing-05dda554b6e69114","kind":"hospital_web","url":"https://www.bannerhealth.com/-/media/files/project/bh/patients-visitors/billing/financial-assistance/2026-documents/lassen-financial-assistance-policy-12126-clean-1192026.pdf","title":"Banner Lassen Medical Center Financial Assistance Policy ...","fetched_on":"2026-10-10","sha256":"05dda554b6e691143377eb7a6b4627a51e21034a270ad80c9aa9d0ca08d1d63d","effective_date":null},{"id":"billing-63f958a8db8b2c31","kind":"hospital_web","url":"https://www.bannerhealth.com/-/media/files/project/bh/patients-visitors/billing/financial-assistance/2023-documents/770-fa-banner-hospitals.ashx","title":"Banner Health Financial Assistance Policy for Hospital ...","fetched_on":"2026-10-10","sha256":"63f958a8db8b2c31c7e38146e42db5165d44b98efc706496e2efea2587fcd342","effective_date":null},{"id":"summary-07052317a62017c3","kind":"hospital_web","url":"https://www.bannerhealth.com/-/media/files/project/bh/patients-visitors/billing/financial-assistance/2025-documents/banner-health-amounts-generally-billed-summary-2025-english.pdf","title":"Amounts Generally Billed (AGB) Calculation Summary - 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