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PDFWAC 296-23A-0550

Under what circumstances will the department pay for interim bills?

The department will deny interim bills which are assigned to diagnosis-related-groups (DRGs) paid per case rates by the department.
If an interim bill is coded as a diagnosis-related-group (DRG) not paid per case rates by the department, then the bill will be paid using the applicable percent of allowed charges (POAC) factor and per diem rates. If a subsequent bill coded as a DRG paid per case rates by the department, for the same injured worker, has a first date of service within seven days of the last date of service of the previous bill, then the bills will be subject to review and adjustment by the department.
[Statutory Authority: RCW 51.04.020, 51.04.030 and 51.36.080. WSR 97-06-066, ยง 296-23A-0550, filed 2/28/97, effective 4/1/97.]
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