Radiology Benefit Management

The term specialized radiology is used for scans and include all types of scans such as computed tomography (CT) scans, magnetic resonance imaging (MRI) scans and positron emission tomography (PET) scans.

All of these services must be pre–authorised in order for the Scheme to cover the associated expenses.

The member or dependant, a family member with the necessary information, the radiologist’ rooms or referring provider can all call in to obtain an authorisation number. Clinical information to support to motivate the application for funding will be required in order for authorisation to be granted and this information is usually supplied by the referring provider.

Member number
Name of member or beneficiary and date of birth
Date of CT/MRI/ PET scan
Name of the treating specialist/referring specialist and the practice number
Name of the radiologist and practice number
The reason for the CT/MRI/ PET scan
The ICD–10 code/s
Tariff codes to be used for the CT/MRI/ PET scan