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Washington Administrative Code (Last Updated: November 23, 2016) |
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Title 296. Labor and Industries, Department of |
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Chapter 296-23A. Hospitals. |
Section 296-23A-0230. How does the department or self-insurer pay out-of-state hospitals for hospital services?
Latest version.
- The department or self-insurer pays out-of-state hospitals for hospital services using a percent of allowed charges (POAC) factor or department fee schedule. The POAC factor may differ for services performed in inpatient and outpatient settings. Payment rates to hospitals located outside of Washington state are calculated by multiplying the out-of-state percent of allowed charges factor (POAC) by the allowed charges.Amount paid = (out-of-state POAC Factor) X (Allowed Charges).Out-of-state hospital providers should bill and the department or self-insurer will pay out-of-state hospitals services according to the following table:[Statutory Authority: RCW 51.04.020, 51.36.080, 7.68.030, 7.68.080. WSR 07-08-088, § 296-23A-0230, filed 4/3/07, effective 5/23/07. Statutory Authority: RCW 51.04.020, 51.04.030, 51.36.080. WSR 00-09-078, § 296-23A-0230, filed 4/18/00, effective 7/1/00; WSR 97-06-066, § 296-23A-0230, filed 2/28/97, effective 4/1/97.]