Ancillary providers
Get information about provider recognition or joining the Bupa Members First Network, or download any relevant Ancillary provider forms and documents.
Medical providers
Get information about the Bupa Medical Gap Scheme, medical claiming and patient eligibility, or arrangements for diagnostic service providers.
Hospital providers
Get information about accessing benefit statements online, hospital claiming and patient eligibility checking, or download relevant forms and documents.
To enhance our Members First Network, Bupa has engaged HICAPS and HealthPoint to activate their adjusted charge processing feature. This will help to reduce the risk of overcharging through HICAPS and HealthPoint terminals, which simplifies the payment process, ensures price certainty for patients, and reduces administrative burdens for Members First Network providers. No action has been (or will be) required by you to enable this change.
HICAPS terminals were enabled with the adjusted charge processing (max fee compliance) on 12 August 2025 as advised, and we continue to work with HealthPoint and their partners to enable these features over coming months. Enablement dates will vary depending on the individual channel partner (banking institution) activation dates. In the meantime, we will continue to monitor any overcharges for max fee compliance regardless of their submission channel or terminal.
If your organisation has access to the Partner Portal and you need to be set up as a user, please speak to a Portal Administrator in your organisation. If your organisation does not have access to the Partner Portal, or if a Portal Administrator needs to be added, please complete the Bupa Partner Portal Access Form (PDF, 162KB).
From 1 July 2026, new Australian Government requirements will apply to how Assignment of Benefit (AoB) consent is obtained, recorded and supported when submitting claims.
Providers should review and update their billing and administrative processes ahead of 1 July 2026 to ensure they align with the new requirements.
To support efficient claims processing and payment
- Providers must obtain, record and retain evidence of the patient's consent (or authorised representative) in accordance with the new AoB requirements.
- Manually submitted claims to Bupa under Simplified Billing should include the required assignment declaration wording in line with Department of Health requirements. Claims without this declaration will be rejected.
- For claims for benefits assigned through implied assignment, providers should include the following copy on the invoice: "This claim for Medicare benefits has been assigned under implied assignment.".
- Claims that meet AoB requirements will continue to be processed and paid through existing claiming arrangements.
Preparing for implementation
To help avoid payment delays, providers should ensure their consent, record-keeping and claiming processes are updated before 1 July 2026.
Where to go for guidance
- Refer to Department of Health and Aged Care guidance and FAQs for detailed requirements.
- For technical or compliance queries, contact the Department directly.
Healthscope has announced ownership changes across parts of its hospital network following decisions made by Healthscope and its Administrators.
A number of ownership outcomes have now been confirmed (outlined below). These changes relate to hospital ownership and governance, not to provider access arrangements.
There are no changes to referral pathways, service access, or Bupa Medical Gap Scheme arrangements at any Healthscope hospital. Providers and patients can continue to access facilities and deliver care under existing arrangements.
Northern Beaches Hospital transitioned to Northern Sydney Local Health District, part of NSW Health, on 29 April 2026 to be part of the public health system, with private treatment options continuing under interim arrangements until 30 June 2027.
This change in ownership does not affect referral pathways, service access, or Bupa Medical Gap Scheme arrangements. Providers should continue usual referral, admission, billing and informed financial consent processes.
Bupa continues to work closely with hospital operators, incoming owners and government authorities to support continuity of care and minimise disruption for patients and providers.
Confirmed ownership transitions (private operators)
The following ownership arrangements have been confirmed:
- Gold Coast Private Hospital
Ownership to transfer to Mater
Transition timing TBC - Hobart Private Hospital
Ownership to transfer to Calvary Health
Transition timing TBC - Holmesglen Private Hospital
Ownership to transfer to Calvary Health
Transition timing TBC - National Capital Private Hospital
Ownership to transfer to Ramsay Health Care
Transition timing TBC
For these hospitals, ownership changes do not affect service access, referral pathways or Medical Gap Scheme arrangements.
Remaining Healthscope hospitals
There are a number of hospitals remaining in the Healthscope portfolio where ownership outcomes have not yet been finalised.
Recent media coverage has indicated that Calvary Health and Pacific Equity Partners (PEP) are among several parties that have lodged bids for the remaining 31 Healthscope hospitals. At this stage, no further details have been confirmed.
For these hospitals:
- Ownership remains unchanged at this time
- No changes to referral pathways, service access or Bupa Medical Gap Scheme arrangements
- Providers should continue usual clinical, admission and billing processes
Ongoing updates
This page will be updated as further ownership decisions are confirmed, or if any changes occur that affect provider access arrangements.
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