No, we are happy to contract with any provider who agrees to the new terms.

Yes, we are happy to consider acceptance at a later stage, if you choose to decline the terms initially.

Our objectives are:

1. pricing for radiology services that is consistent across providers and that is at levels that are competitive, efficient and sustainable; and
2. ensuring high levels of service and value for our members through consistently applied service standards for radiology services.

Our objective is a sustainable radiology sector that delivers value to our members. We have listened to feedback from providers and taken that feedback on board when formulating our new approach. As part of this, we have arranged for comprehensive pricing analysis to be conducted, including independent benchmarking against national and international markets. We are satisfied that our new pricing is efficient, competitive, and sustainable for Southern Cross, our members, and our radiology providers.

As the funder, we are not involved in the referral pathway. We trust that referring practitioners request appropriate imaging. We acknowledge that radiologists play an important role in ensuring any imaging undertaken balances the risks and benefits to the member, including repeat procedures. This may mean adjusting the radiology services delivered from those requested.

We are introducing service levels into the new AP agreement. These will outline the value we are seeking on behalf of our members.

Radiology services are AP only, which means for members to receive funding under their policy, it must be performed by an Affiliated Provider (excluding UltraCare plans). We are happy to add any additional locations or enter into new AP agreements with any new facilities who can meet the standardised terms and conditions.

The system will apply a discount to second or subsequent scans when performed together in the same modality. The system will pay the most expensive scan at full price, then discount the second and any subsequent scans. For scans across different modalities, (e.g. MRI and ultrasound) - the discount will not apply. The percentage discount will be the same for all providers.

Any services that are out of scope in the new schedule can be transferred to the new Affiliated Provider agreement. These services will be included as a separate Appendix and will be subject to the existing pricing and price review terms as your current Affiliated Provider agreement. Examples of these services include consultations and surgical procedures. The new service levels and “one referral, one appointment” principle will not apply to these services.

Following feedback, we have accommodated contrast to be used only when required and not built it into the base scan price. We have also recognised the more expensive contrast mediums.

The price review mechanism will be included in the draft AP agreement being supplied with the Proposed Agreement Change Request (PACR).

Yes, any updates to the codes will be notified to you. If you choose to add the new codes to your AP agreement, this will be recorded in a variation and signed by both of us.