Help Paying Your Bill

UC Davis Health strives to provide quality patient care and meet high standards for the communities we serve. This policy demonstrates UC Davis Health’s commitment to our mission and vision by helping to meet the needs of low income, uninsured and underinsured patients in our community.

Eligible Services

The Financial Assistance Program applies to emergency or other medically necessary health care services provided and billed by UC Davis Health. Services that are separately billed by other/non-UC Davis Health providers are not eligible for consideration under the Financial Assistance Program.

Determination of Eligibility

Eligibility is determined based on review of a completed Financial Screening Form and supporting documents, including proof of income, assets and liabilities. Generally, patients with family income at or below 400% of the Federal Poverty Level will be eligible for a discount of 100%.

If you receive financial assistance under our policy, you will not be charged more for emergency or other medically necessary care than the amount generally billed (AGB) to patients having Medicare coverage.

To view the U.S. federal poverty guidelines used to determine financial eligibility, visit the HHS poverty guidelines website.

How to Obtain Copies of our Financial Assistance Program Policy and Application

You may obtain a copy of our Financial Assistance Policy and Application:

On this page below
In our Emergency Department, Financial Clearance Department (see address below), any UC Davis Health location where patient registration occurs, and in our Patient Billing Customer Service Office (see address below)
To request documents by mail, contact the Patient Billing Customer Service Office at 916-734-9200 or 1-800-551-9411 (Monday–Friday, 8:30 a.m. to 4:00 p.m.)
To request documents by email, first read and sign this email consent form and send to the Patient Billing Customer Service Department at hs-patientbilling@ucdavis.edu

Languages and Translations

The Financial Assistance Program Policy, the program application (called the “Patient Financial Information Form”), and a Plain Language Summary of the program are available in English, Spanish, Hmong, Chinese, Lao and Russian in the “Documents” section below on this page, or separately upon request.

How to Apply for our Financial Assistance Program

To apply for the Financial Assistance Program, mail or hand-deliver the Financial Assistance Application form found below, with all supporting documents, to:

Mailed to:
UC Davis Health Patient Billing
Attn: FA Program
PO Box 168015
Sacramento, CA 95816-9979

Hand-delivery:
Monday – Friday 8:30 a.m. to 4 p.m.
Financial Clearance Department
4301 X St., Suite 1P214
Sacramento, CA 95817

Financial Assistance Program Documents

English

Poverty Guidelines for Financial Eligibility

To view U.S. federal poverty guidelines used to determine financial eligibility for certain federal programs, visit the HHS poverty guidelines website.

There are free consumer advocacy organizations that will help you understand the billing and payment process. You may call the Health Consumer Alliance at 888-804-3536 or go to healthconsumer.org for more information.

Hospital Bill Complaint Program

The Hospital Bill Complaint Program is a state program, which reviews hospital decisions about whether you qualify for help paying your hospital bill. If you believe you were wrongly denied financial assistance, you may file a complaint with the Hospital Bill Complaint Program. Go to HospitalBillComplaintProgram.hcai.ca.gov for more information and to file a complaint.

Patient Billing Customer Service Dispute Contacts:

Pawan Gautam or Billing Office Manager
Executive Director of Revenue Services
Email: hs-patientbilling@ucdavis.edu
Phone: 916-734-9200 or 800-551-9411 or 916-734-9230 (TDD/hearing impaired)

Questions?

If you have questions about billing, insurance or financial arrangements, please email or call the appropriate phone number below:

Hospital bill before discharge (Financial Clearance Department):

Hospital bill after discharge, doctors’ fees or outpatient services bill (Patient Billing Customer Service):

Note: For all email communication between the Patient Billing Customer Service Department, patients must first read and sign this email consent form and send to hs-patientbilling@ucdavis.edu.

Availability notice

Financial assistance program documents availability notice (IRS 501(r) disclosure)

Help Paying Your Bill | Patients & Visitors | UC Davis Health