This report provides detailed information regarding radiology cost and utilization with a header containing critical metrics for comparison and trending.  Detailed member analysis by selecting a patient with radiology services and detailed service analysis by selecting a cost by type is available using this report.



Target Audience for this Report 

Chief Medical Officer, Finance Department and CFO, Leadership Team, Medical management/Care Management Department, Pharmacy & Therapeutics Committee, Quality Management, and Utilization Management.


Business Processes Impacted by this Report

This detailed cost and utilization data supports the analysis of an important cost driver which leads to improved provider education.  Header provides a snapshot of radiology information which is useful for finance, medical management, and provider relations to track and trend.  Targeted strategies for areas of potential savings will be developed and priorities identified.  Offers predictive value for costs.


Detail and Definitions

The header information; “Radiology Groups”, “Patients w/Radiology Services”, “Total Paid for Radiology”, “Paid/Claim”, and “Procedure Rate/1000” based on the reporting data date range   Radiology services are based off of the service type on the medical claims.  Note that the header information is active, and will change when selections are made/filters are applied.


Radiology Claims and Cost by Type (Graphs)

  • Top graph is by Rates per 1000 members for radiology type.  
  • Bottom graph is by total paid for radiology Type.

Top Referring PCPs

  • PCP Name
  • Rate/1000
  • Patients
  • Total Costs


Patient with Radiology Services

  • Member Number
  • Member Name
  • Claims – Total Radiology claims
  • Paid/Claim – Average paid per claim
  • Risk Score – ACG Risk Score


Member Visit Detail

  • Member Number
  • Member Name
  • Claim #
  • Service Date
  • Procedure
  • Diagnosis
  • POS – Place of Service



Note that filtering order in the visualization is:

  1. Claim and Cost Type (not a required selection)
  2. Top Referring PCP
  3. Patients with Radiology Services


Trending Graphs

Accessed by clicking on the graph icon in the upper right of the report.

Period by Period Trends (Graph)

Displays the trends of Rates per 1000 by the selected period; year, quarter, or month.  The graph changes with applied filters found in the header.  This snapshot of these indicators provides significant information regarding Radiology Rates and the graphical display provides quick reference points to guide a deeper analysis.


Period Over Period Trends (Graph)

Displays the selected time period trends Radiology Rates in percentages over the previous period.  The graph changes with the applied filters found in the header.  By describing period over period in this manner the user can easily determine progress or decline in the indicators.