Washington · Regulations
Chapter 296-23A — HOSPITALS
52 sections
52 sections
- WAC 296-23A-0100WAC 296-23A-0100. Where can I find general information and rules pertaining to the care of workers?
- WAC 296-23A-0110WAC 296-23A-0110. When will the department or self-insurer pay for hospital services?
- WAC 296-23A-0120WAC 296-23A-0120. What services are subject to review by the department or self-insurer?
- WAC 296-23A-0130WAC 296-23A-0130. How does the department establish hospital payment rates?
- WAC 296-23A-0140WAC 296-23A-0140. How can interested persons request advance notice of changes to hospital payment rates, methods and policies?
- WAC 296-23A-0150WAC 296-23A-0150. How must hospitals submit bills for hospital services?
- WAC 296-23A-0160WAC 296-23A-0160. How must hospitals submit charges for ambulance and professional services?
- WAC 296-23A-0170WAC 296-23A-0170. How must hospitals bill the department or self-insurer for preadmission services?
- WAC 296-23A-0180WAC 296-23A-0180. What supporting documentation must hospitals send for hospital services?
- WAC 296-23A-0190WAC 296-23A-0190. Where must hospitals send supporting documentation for hospital services for state fund claims?
- WAC 296-23A-0195WAC 296-23A-0195. When must providers using electronic medium submit supporting documentation?
- WAC 296-23A-0200WAC 296-23A-0200. How does the department pay for hospital inpatient services?
- WAC 296-23A-0210WAC 296-23A-0210. How do self-insurers pay for hospital inpatient services?
- WAC 296-23A-0220WAC 296-23A-0220. How does the department pay for hospital outpatient services?
- WAC 296-23A-0221WAC 296-23A-0221. How does the self-insurer pay for hospital outpatient services?
- WAC 296-23A-0230WAC 296-23A-0230. How does the department or self-insurer pay out-of-state hospitals for hospital services?
- WAC 296-23A-0240WAC 296-23A-0240. How does the department define and pay a new hospital?
- WAC 296-23A-0250WAC 296-23A-0250. Does a change in hospital ownership affect a hospital's payment rate?
- WAC 296-23A-0300WAC 296-23A-0300. When do percent of allowed charges (POAC) payment factors apply?
- WAC 296-23A-0310WAC 296-23A-0310. What is the method for calculating percent of allowed charges (POAC) factors?
- WAC 296-23A-0350WAC 296-23A-0350. When do per diem rates apply?
- WAC 296-23A-0360WAC 296-23A-0360. What is the method for calculating per diem rates?
- WAC 296-23A-0400WAC 296-23A-0400. What is a "diagnosis-related-group" payment system?
- WAC 296-23A-0410WAC 296-23A-0410. How does the department calculate diagnosis-related-group (DRG) relative weights?
- WAC 296-23A-0420WAC 296-23A-0420. How does the department determine the base price for hospital services paid using per case rates?
- WAC 296-23A-0430WAC 296-23A-0430. How does the department calculate a hospital specific case-mix adjusted average cost per case?
- WAC 296-23A-0440WAC 296-23A-0440. How does the department calculate the base price for DRG hospitals, except major teaching hospitals?
- WAC 296-23A-0450WAC 296-23A-0450. What cases does the department exclude from base price calculations?
- WAC 296-23A-0460WAC 296-23A-0460. How does the department calculate the diagnosis-related-group (DRG) per case payment rate for a particular hospital?
- WAC 296-23A-0470WAC 296-23A-0470. Which exclusions and exceptions apply to diagnosis-related-group (DRG) payments for hospital services?
- WAC 296-23A-0480WAC 296-23A-0480. Which hospitals does the department exclude from diagnosis-related-group (DRG) payments?
- WAC 296-23A-0490WAC 296-23A-0490. Which hospital services does the department include in diagnosis-related-group (DRG) rates?
- WAC 296-23A-0500WAC 296-23A-0500. When does a case qualify for high outlier status?
- WAC 296-23A-0520WAC 296-23A-0520. How does the department pay for high outlier cases?
- WAC 296-23A-0530WAC 296-23A-0530. How does a case qualify for low outlier status?
- WAC 296-23A-0540WAC 296-23A-0540. How does the department pay for low outlier cases?
- WAC 296-23A-0550WAC 296-23A-0550. Under what circumstances will the department pay for interim bills?
- WAC 296-23A-0560WAC 296-23A-0560. How does the department define and pay for hospital readmissions?
- WAC 296-23A-0570WAC 296-23A-0570. How does the department define a transfer case?
- WAC 296-23A-0575WAC 296-23A-0575. How does the department pay a transferring hospital for a transfer case?
- WAC 296-23A-0580WAC 296-23A-0580. How does the department pay the receiving hospital for a transfer case?
- WAC 296-23A-0600WAC 296-23A-0600. How can a hospital request a rate adjustment?
- WAC 296-23A-0610WAC 296-23A-0610. Where must hospitals submit requests for rate adjustments?
- WAC 296-23A-0620WAC 296-23A-0620. What action will the department take upon receipt of a request for a rate adjustment?
- WAC 296-23A-0700WAC 296-23A-0700. What is the "ambulatory payment classification" (APC) payment system?
- WAC 296-23A-0710WAC 296-23A-0710. Definitions
- WAC 296-23A-0720WAC 296-23A-0720. How does the department calculate the hospital-specific per APC rate used for paying outpatient services under the outpatient prospective payment system (OPPS)?
- WAC 296-23A-0730WAC 296-23A-0730. How does the department determine the APC relative weights?
- WAC 296-23A-0740WAC 296-23A-0740. How does the department calculate payments for covered outpatient services through the outpatient prospective payment system (OPPS)?
- WAC 296-23A-0750WAC 296-23A-0750. What exclusions and exceptions apply to ambulatory-payment-classification (APC) payments for hospital services?
- WAC 296-23A-0770WAC 296-23A-0770. How will excluded outpatient services and hospitals be paid?
- WAC 296-23A-0780WAC 296-23A-0780. What information needs to be submitted for the hospital to be paid for outpatient services?