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 data base, excluding statistical outliers.
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