DEFINITION
The MHS Radiology Management Programme has as its objective the facilitation of rational, appropriate and cost-effective radiology services to members of client medical schemes. It comprises the following elements:

IN RESPECT OF SPECIALIST RADIOLOGISTS:

• Radiology claims adjudication and audit,

• Radiologist Profiles and Utilisation Review,

• The development of Best Practice Radiology guidelines in conjunction with national opinion leaders,

• The monitoring of radiology practice adherence to these Best Practice guidelines by auditing of claims.

IN RESPECT OF GENERAL PRACTITIONERS AND CLINICAL SPECIALISTS:

• Inclusion of radiology service parameters as a component of MHS Practice Profiles,

• Interaction with existing MHS Coordinated Provider Networks for the implementation of radiology Benchmarks and Clinical Rules and generally for the promotion of rational, appropriate and cost-effective utilisation of radiology services,

• Ongoing evaluation of the level and appropriateness of radiology services provided by practitioners in their rooms,

• Interventions with practitioners in respect of adherence to Best Practice Radiology guidelines,

• Radiology Account Audit and Review.

• Cost-effective use and consumption of radiology resources,

• Analyses and reports on radiology services performed by individual Radiology facilities and practitioners,

• Ongoing monitoring and maintenance of the adopted Best Practice guidelines as necessitated by the development of knowledge, technology and standards of practice,

• Interventions with radiology facilities and practitioners based on the above.