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PDFWAC 296-23A-0530

How does a case qualify for low outlier status?

To qualify as a low outlier, the allowed charges multiplied by that hospital's percent of allowed charges (POAC) factor must be less than ten percent of the statewide diagnosis-related-group (DRG) rate or five hundred dollars whichever is greater. The standard deviations for DRGs will be computed from all relevant cases in the historical database, excluding statistical outliers.
[Statutory Authority: RCW 51.04.020, 51.04.030 and 51.36.080. WSR 97-06-066, ยง 296-23A-0530, filed 2/28/97, effective 4/1/97.]