Laserfiche WebLink
EXHIBIT B-4-A <br />THIRD PARTY HEALTH BENEFIT EXCHANGE <br />REIMBURSEMENT RATES <br />1. Rates. Subject to the terms of the Agreement, reimbursement rates for Covered Services <br />billed under Facility's federal tax ID number for the Third -Party Benefit Plans listed below <br />shall be the lesser of billed charges or the following, and will be less any applicable Cost <br />Sharing Amounts. <br />A. CHPW-Affiliated "Cascade Care" Public Option Plans: <br />Network Name: CHPW Cascade Care Affiliate Network <br />Inpatient Services: {Rate - Exchange}% of Medicare Fee Schedule <br />for all Covered Services described therein; and <br />{Rate - Exchange}% of the Washington State <br />Health Care Authority's ("HCA's") Apple Health <br />(Medicaid) Fee Schedule for all Covered Services <br />for which no Medicare fee exists. <br />Outpatient Services: {Rate - Exchange} % of Medicare Fee Schedule <br />for all Covered Services described therein; and <br />{Rate - Exchange}% of the Washington State <br />Health Care Authority's ("HCA's") Apple Health <br />(Medicaid) Fee Schedule for all Covered Services <br />for which no Medicare fee exists. <br />Professional Services: {Rate - Exchangel % of Medicare Fee Schedule <br />for all Covered Services described therein; and <br />3Rate - Exchange}% of the Washington State <br />Health Care Authority's ("HCA's") Apple Health <br />(Medicaid) Fee Schedule for all Covered Services <br />for which no Medicare fee exists. <br />B. Non -Affiliated "Cascade Care" Public Option Plans: <br />Network Name: CHPW Cascade Care Non -Affiliate Network <br />Inpatient Services: {Rate - Exchange}% of Medicare Fee Schedule <br />for all Covered Services described therein; and <br />{Rate - Exehangel% of the Washington State <br />Health Care Authority's ("HCA's") Apple Health <br />(Medicaid) Fee Schedule for all Covered Services <br />for which no Medicare fee exists. <br />2021 Facility Exh B4A— 3PHBERates Page 48 of 51 Contract #{Contract #1-{PRC Agreement IDl <br />