PDF TAR County DSH Neg Rate

FILE 34 INPATIENT CONSOLIDATION PAID CLAIMS FISCAL YEAR 2016-17

BY COUNTY OF TAR AND PROVIDER NUMBER AS OF MARCH 2018

Enclosure 2

Threshold amount = The higher figure of 5% of Amount Paid or $20,000. DSH = Disproportionate Share Hospital. If Neg. Rate = Y (yes) MHP must negotiate with the hospital provider. *BHC FREMONT HOSPITAL (NPI: 1245346741) = RATE NEGOTIATION DELEGATED BY ALAMEDA TO SANTA CLARA PER TITLE 9, SECT

TAR County Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Alameda Threshold:

NPI

1457489502 1245346741 1528066685 1215373626 1922039205 1104906569 1568445419 1215962782 1548328750 1356410351 1154308005 1023010113 1851381990 1720078082 1154500510 $247,572

Provider Legal Name

ALTA BATES SUMMIT MED CT BHC FREMONT HOSP BHC SIERRA VISTA HOSPITAL CHLB LLC COLLEGE HOSP COSTA MESA FRESNO COMMUNITY HOSPITAL GROSSMONT HOSP JOHN MUIR HEALTH PACIFICA OF THE VALLEY PRIME HLTHCARE PARADISE VLY SCRIPPS HEALTH SOUTHERN CALIFORNIA ST HELENA HOSP CTR FOR ST HELENA HOSPITAL UNIVERSITY OF CA IRVINE

Provider City

Berkeley Fremont Sacramento Long Beach Costa Mesa Fresno La Mesa Concord Sun Valley National City San Diego Van Nuys Vallejo Deer Park Irvine

Provider County Alameda Alameda Sacramento Los Angeles Orange Fresno San Diego Contra Costa Los Angeles Los Angeles San Diego Los Angeles Solano Napa Orange

DSH Neg Rate

* Y Y Y Y Y

Y Y Y Y Y Y Y

Amador

Amador

1922378215 AURORA BEHAVIORAL HEALTHCARE

Santa Rosa

Sonoma

Amador

1245346741 BHC FREMONT HOSP

Fremont

Alameda

*

Amador

1083709653 BHC HERITAGE OAKS HOSP

Sacramento

Sacramento

Amador

1548399736 DOCTORS MEDICAL CENTER

Modesto

Stanislaus

Amador

1215962782 JOHN MUIR HEALTH

Concord

Contra Costa

Threshold:

$20,000

Butte

Butte Butte Butte Butte Butte Butte Butte Butte Butte Butte Threshold

Calaveras Calaveras Calaveras Calaveras Calaveras Calaveras Calaveras Calaveras Calaveras Threshold

Colusa

Colusa Colusa Colusa Colusa Colusa Colusa Colusa Threshold

Contra Costa

Contra Costa Contra Costa Contra Costa Contra Costa Contra Costa Contra Costa

1922378215 1245346741 1083709653 1528066685 1215962782 1013061597 1548328750 1356410351 1851381990 1720078082 $69,477

1902863418 1245346741 1083709653 1528066685 1548399736 1215962782 1851381990 1720078082 $20,000

NPI 1922378215 1083709653 1922116037 1215962782 1851381990 1720078082 $20,000

NPI 1457489502 1245346741 1528066685 1104906569 1215962782

AURORA BEHAVIORAL HEALTHCARE BHC FREMONT HOSP BHC HERITAGE OAKS HOSP BHC SIERRA VISTA HOSPITAL JOHN MUIR HEALTH MISSION COMM HOSP PACIFICA OF THE VALLEY PRIME HLTHCARE PARADISE VLY ST HELENA HOSP CTR FOR ST HELENA HOSPITAL

AURORA VISTA DEL MAR LLC BHC FREMONT HOSP BHC HERITAGE OAKS HOSP BHC SIERRA VISTA HOSPITAL DOCTORS MEDICAL CENTER JOHN MUIR HEALTH ST HELENA HOSP CTR FOR ST HELENA HOSPITAL

Provider Legal Name AURORA BEHAVIORAL HEALTHCARE BHC HERITAGE OAKS HOSP DIGNITY HEALTH JOHN MUIR HEALTH ST HELENA HOSP CTR FOR ST HELENA HOSPITAL

Provider Legal Name ALTA BATES SUMMIT MED CT BHC FREMONT HOSP BHC SIERRA VISTA HOSPITAL FRESNO COMMUNITY HOSPITAL JOHN MUIR HEALTH

Santa Rosa Fremont Sacramento Sacramento Concord Panorama City Sun Valley National City Vallejo Deer Park

Sonoma Alameda Sacramento Sacramento Contra Costa Los Angeles Los Angeles Los Angeles Solano Napa

*

Y

Y Y Y Y Y

Ventura Fremont Sacramento Sacramento Modesto Concord Vallejo Deer Park

Ventura Alameda Sacramento Sacramento Stanislaus Contra Costa Solano Napa

Y *

Y

Y Y

Santa Rosa Sacramento Woodland Concord Vallejo Deer Park

Sonoma

Sacramento

Yolo

Contra Costa

Solano

Y

Napa

Y

Berkeley Fremont Sacramento Fresno Concord

Alameda Alameda Sacramento Fresno Contra Costa

* Y Y

Contra Costa Contra Costa Contra Costa Contra Costa Contra Costa Threshold

Del Norte

Del Norte Del Norte Del Norte Del Norte Del Norte Del Norte Del Norte Threshold

El Dorado

El Dorado El Dorado El Dorado El Dorado El Dorado El Dorado El Dorado El Dorado El Dorado El Dorado Threshold

Fresno

Fresno Fresno Fresno Fresno Fresno Fresno Fresno Fresno Fresno Fresno

1922015833 1548328750 1851381990 1720078082 1154500510 $186,550

NPI 1922378215 1245346741 1083709653 1528066685 1922116037 1851381990 $20,000

NPI 1730287319 1083709653 1528066685 1215373626 1922116037 1215962782 1851381990 1720078082 1952350944 $25,448

NPI 1457470700 1366419517 1902863418 1528066685 1215373626 1922039205 1104906569 1467413708 1376623538

LOMA LINDA UNIVERSITY PACIFICA OF THE VALLEY ST HELENA HOSP CTR FOR ST HELENA HOSPITAL UNIVERSITY OF CA IRVINE

Provider Legal Name AURORA BEHAVIORAL HEALTHCARE BHC FREMONT HOSP BHC HERITAGE OAKS HOSP BHC SIERRA VISTA HOSPITAL DIGNITY HEALTH ST HELENA HOSP CTR FOR

Provider Legal Name BHC HEALTH SERVICES OF NV BHC HERITAGE OAKS HOSP BHC SIERRA VISTA HOSPITAL CHLB LLC DIGNITY HEALTH JOHN MUIR HEALTH ST HELENA HOSP CTR FOR ST HELENA HOSPITAL SUTTER VALLEY HOSPITALS

Provider Legal Name ANAHEIM GLOBAL MEDICAL ANTELOPE VALLEY HEALTHCARE AURORA VISTA DEL MAR LLC BHC SIERRA VISTA HOSPITAL CHLB LLC COLLEGE HOSP COSTA MESA FRESNO COMMUNITY HOSPITAL KAWEAH DELTA DIST HOSP KERN COUNTY HOSPITAL

Redlands Sun Valley Vallejo Deer Park Irvine

Santa Rosa Fremont Sacramento Sacramento Woodland Vallejo

Reno Sacramento Sacramento Long Beach Woodland Concord Vallejo Deer Park Sacramento

Anaheim Lancaster Ventura Sacramento Long Beach Costa Mesa Fresno Visalia Bakersfield

San Bernardino Y

Los Angeles

Y

Solano

Y

Napa

Y

Orange

Y

Sonoma Alameda Sacramento Sacramento Yolo Solano

* Y Y

State of NV

Sacramento

Sacramento

Y

Los Angeles

Y

Yolo

Contra Costa

Solano

Y

Napa

Y

Sacramento

Orange

Y

Los Angeles

Y

Ventura

Y

Sacramento

Y

Los Angeles

Y

Orange

Y

Fresno

Y

Tulare

Kern

Y

Fresno Fresno Fresno Fresno Fresno Fresno Fresno Fresno Fresno Fresno Threshold

Glenn

Glenn Glenn Glenn Glenn Glenn Glenn Glenn Glenn Glenn Threshold

Humboldt

Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt Humboldt

1013061597 1548328750 1942247291 1154308005 1023010113 1487697215 1851381990 1720078082 1154500510 1215927470 $1,093,422

NPI 1922378215 1245346741 1528066685 1215373626 1922116037 1215962782 1851381990 1265581086 $14,131

NPI 1457489502 1366419517 1922378215 1528066685 1215373626 1932243003 1548399736 1104906569 1215962782 1356410351 1376641969 1154308005 1851381990 1720078082

MISSION COMM HOSP PACIFICA OF THE VALLEY PROVIDENCE HEALTH SYSTEM SCRIPPS HEALTH SOUTHERN CALIFORNIA ST FRANCIS MEDICAL CTR ST HELENA HOSP CTR FOR ST HELENA HOSPITAL UNIVERSITY OF CA IRVINE WHITE MEMORIAL MED CTR

Provider Legal Name AURORA BEHAVIORAL HEALTHCARE BHC FREMONT HOSP BHC SIERRA VISTA HOSPITAL CHLB LLC DIGNITY HEALTH JOHN MUIR HEALTH ST HELENA HOSP CTR FOR STANFORD HOSPITAL

Provider Legal Name ALTA BATES SUMMIT MED CT ANTELOPE VALLEY HEALTHCARE AURORA BEHAVIORAL HEALTHCARE BHC SIERRA VISTA HOSPITAL CHLB LLC DIGNITY HEALTH DOCTORS MEDICAL CENTER FRESNO COMMUNITY HOSPITAL JOHN MUIR HEALTH PRIME HLTHCARE PARADISE VLY REGENTS OF THE UNVERSITY SCRIPPS HEALTH ST HELENA HOSP CTR FOR ST HELENA HOSPITAL

Panorama City

Los Angeles

Y

Sun Valley

Los Angeles

Y

San Pedro

Los Angeles

Y

San Diego

San Diego

Y

Van Nuys

Los Angeles

Y

Lynwood

Los Angeles

Y

Vallejo

Solano

Y

Deer Park

Napa

Y

Irvine

Orange

Y

Los Angeles

Los Angeles

Y

Santa Rosa Fremont Sacramento Long Beach Woodland Concord Vallejo Stanford

Sonoma Alameda Sacramento Los Angeles Yolo Contra Costa Solano Santa Clara

* Y Y

Y

Berkeley Lancaster Santa Rosa Sacramento Long Beach San Francisco Modesto Fresno Concord National City San Diego San Diego Vallejo Deer Park

Alameda

Los Angeles

Y

Sonoma

Sacramento

Y

Los Angeles

Y

San Francisco

Stanislaus

Fresno

Y

Contra Costa

San Diego

Y

San Diego

Y

San Diego

Y

Solano

Y

Napa

Y

Threshold

Imperial

Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Imperial Threshold

Inyo

Inyo Inyo Inyo Inyo Inyo Inyo Inyo Inyo Inyo Threshold

Kern

Kern Kern Kern Kern Kern Kern Kern Kern

$20,251

NPI 1619934114 1598722027 1902863418 1528066685 1477969970 1215373626 1922039205 1477610640 1568445419 1356410351 1376641969 1154308005 1720078082 1770558710 $20,620

NPI 1902863418 1730287319 1902825128 1245203447 1023140464 1376623538 1023010113 1952350944 $20,000

NPI 1366419517 1902863418 1700259165 1528066685 1215373626 1922039205 1477610640

Provider Legal Name AURORA CHARTER OAK AURORA SAN DIEGO, LLC AURORA VISTA DEL MAR LLC BHC SIERRA VISTA HOSPITAL BH-SD OPCO LLC CHLB LLC COLLEGE HOSP COSTA MESA DIGNITY HEALTH GROSSMONT HOSP PRIME HLTHCARE PARADISE VLY REGENTS OF THE UNVERSITY SCRIPPS HEALTH ST HELENA HOSPITAL TRI-CITY MEDICAL CTR

Provider Legal Name AURORA VISTA DEL MAR LLC BHC HEALTH SERVICES OF NV CANYON RIDGE HOSPITAL DEL AMO HOSPITAL INC HENRY MAYO NEWHALL KERN COUNTY HOSPITAL SOUTHERN CALIFORNIA SUTTER VALLEY HOSPITALS

Provider Legal Name ANTELOPE VALLEY HEALTHCARE AURORA VISTA DEL MAR LLC BAKERSFIELD BEHAVIORAL BHC SIERRA VISTA HOSPITAL CHLB LLC COLLEGE HOSP COSTA MESA DIGNITY HEALTH

Covina San Diego Ventura Sacramento La Mesa Long Beach Costa Mesa Glendale La Mesa National City San Diego San Diego Deer Park Oceanside

Los Angeles

San Diego

Ventura

Y

Sacramento

Y

San Diego

Los Angeles

Y

Orange

Y

Los Angeles

Y

San Diego

Y

San Diego

Y

San Diego

Y

San Diego

Y

Napa

Y

San Diego

Ventura Reno Chino Torrance Valencia Bakersfield Van Nuys Sacramento

Ventura

Y

State of Neveda

San Bernardino

Los Angeles

Los Angeles

Kern

Y

Los Angeles

Y

Sacramento

Lancaster Ventura Bakersfield Sacramento Long Beach Costa Mesa Glendale

Los Angeles

Y

Ventura

Y

Kern

Sacramento

Y

Los Angeles

Y

Orange

Y

Los Angeles

Y

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