Ancillary providers

Get information about provider recognition or joining the Bupa Members First Network, or download any relevant Ancillary provider forms and documents.

For ancillary providers
 

Medical providers

Get information about the Bupa Medical Gap Scheme, medical claiming and patient eligibility, or arrangements for diagnostic service providers.

For medical providers
 

Hospital providers

Get information about accessing benefit statements online, hospital claiming and patient eligibility checking, or download relevant forms and documents.

For hospital providers
Helping you with maximum fee adherence

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.
Bupa Partner Portal Hospital, medical and other providers can use the Partner Portal to securely share information with Bupa relating to manual claims and statements, auditing and reporting, and change of detail requests. Partner login

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 the majority 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.

The following hospitals have either already transitioned to new ownership or have a confirmed transition date:

State Hospital New owner Status Additional information
ACT National Capital Private Hospital Ramsay Health Care Transition completed 1 September 2026 n/a
NSW Northern Beaches Hospital NSW Health Transition completed 29 April 2026. Private treatment options remain available under interim arrangements until 30 June 2027.
QLD Gold Coast Private Hospital Mater Group Transition completed 31 July 2026 n/a
TAS Hobart Private Hospital Calvary Health Care Expected transition 1 November 2026* n/a
VIC Holmesglen Private Hospital Calvary Health Care Transition completed 1 October 2026 n/a
WA Mount Hospital Bethesda Health Care Transition completed 24 September 2026 n/a

*Subject to completion of the sale process and any relevant approvals.

Ownership outcomes have now been announced for most of the remaining hospitals in the Healthscope network.*

The table below reflects ownership outcomes that have been announced, however individual hospital transition dates and implementation arrangements are still being finalised.
New owner Hospitals Status
Calvary Health Care 14 hospitals
Norwest Private Hospital, The Hills Private Hospital, Darwin Private Hospital, Griffith Rehabilitation Centre, The Melbourne Clinic, John Fawkner Private Hospital, Brisbane Private Hospital, Lady Davidson Private Hospital, Hunter Valley Private Hospital, The Sydney Clinic, Newcastle Private Hospital, Peninsula Private Hospital, Dorset Rehabilitation Centre, Melbourne Private Hospital		 Intended from 1 December 2026, subject to sale process and regulatory approvals
Healthe Care 6 hospitals
Knox Private Hospital, Northpark Private Hospital, Ringwood Private Hospital, The Geelong Clinic, Victorian Rehabilitation Centre, Prince of Wales Private Hospital 		Intended from 1 December 2026, subject to sale process and regulatory approvals
ACURIO Health 3 hospitals in Greater Western Sydney
Nepean Private Hospital, Sydney Southwest Private Hospital, Campbelltown Private Hospital 		Intended from 1 December 2026, subject to sale process and regulatory approvals
KnG Group 2 hospitals
Sunnybank Private Hospital and Pine Rivers Private Hospital (QLD) 		Intended from 1 December 2026, subject to sale process and regulatory approvals

 
*Two hospitals, La Trobe Private Hospital and The Victoria Clinic, are not part of the consortium outcome. Healthscope has advised that these hospitals are expected to transition to new operators, with further details to be announced once commercial negotiations are completed. Ashford Hospital, Flinders Private Hospital and the Memorial Hospital (the ACHA Hospitals) are yet to be finalised as they transition away from the management agreement with Healthscope.

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Northern Beaches Hospital, located in Frenchs Forest NSW, transitioned from private ownership to the NSW public health system as of 29 April 2026.

While the hospital’s role has expanded, care continues to be delivered to the local community. Private treatment options also remain available under interim arrangements until 30 June 2027, supporting patient safety and continuity of care.

Bupa is sharing this information to help customers understand what this change means and to support informed decisions about care.

Northern Beaches Hospital, located in Frenchs Forest NSW, transitioned from private ownership to the NSW public health system as of 29 April 2026.

While the hospital’s role has expanded, care continues to be delivered to the local community. Private treatment options also remain available under interim arrangements until 30 June 2027, supporting patient safety and continuity of care.

Bupa is sharing this information to help customers understand what this change means and to support informed decisions about care.

Healthscope has made changes to the ownership of some of its hospitals. As part of this process, Northern Beaches Hospital has moved into public ownership and is now part of the NSW public health system.

Decisions about hospital ownership and how services are delivered are made by hospital operators and government. Our role is to support you to understand your options and access the care that’s right for you.

Most planned surgeries continue to be performed at Northern Beaches Hospital, provided they are:

  • clinically appropriate, and
  • within the hospital’s approved service levels.

Private treatment options remain available under interim arrangements until 30 June 2027. During this period, NSW Health is working with clinicians and the community to finalise a longer term model for private services, including investigating opportunities for a co located public-private model on the campus.

An independent advisor, David Swan, has been appointed by the NSW Government to provide advice on future private health opportunities at the hospital.

We recommend speaking directly with your treating doctor to understand your care options and the hospital’s arrangements at the time of your admission. We’re also here to help you navigate your options.

Your treating doctor and the hospital will confirm this with you as part of your admission and informed financial consent process. If you’re unsure, you can check with the hospital directly or contact us, and we’ll help you understand what applies to your situation.

If you’ve previously received private care at Northern Beaches Hospital, there’s nothing you need to do right now.

If you need treatment in the future, we’ll help you understand:

  • whether private care is available at Northern Beaches Hospital under the interim arrangements, or
  • what alternative private hospital options may be suitable for your care.

Not necessarily.

You can still elect to use your private health insurance, subject to:

  • your treatment needs,
  • your doctor’s recommendations, and
  • the hospital’s service arrangements at the time of your care.

Our role is to help you understand your choices and support continuity of care wherever possible.

Your doctor can arrange the transfer of relevant medical information if you attend a different hospital. If you have concerns about continuity of care, your treating doctor is best placed to guide you, and we’re here to support you with any coverage-related questions.

Many specialists work across multiple hospitals.

Your specialist can advise where they practise and what options are available to you. If treatment at another hospital is needed, we can help you understand whether it’s covered under your policy.

Yes. Private treatment continues to be offered under interim arrangements until 30 June 2027.

As the hospital now operates within the NSW public health system, private and public care is delivered within a public hospital framework. Availability of private treatment may depend on:

  • your treating doctor or specialist
  • the type of treatment you need
  • clinical priority and approved service levels

If you’re planning treatment, we recommend checking directly with your doctor or the hospital to understand how your care would be delivered.

No. There is no change to your Bupa policy or hospital cover as a result of this ownership change.

Your cover continues in line with the terms of your policy. What may change is how care is delivered at Northern Beaches Hospital, depending on the hospital’s service model and your treatment pathway.

Out of pocket costs depend on whether you’re treated as a public or private patient.

  • If you’re treated as a public patient, many services are covered by Medicare.
  • If you’re treated as a private patient, different fees may apply, including doctors’ fees, which can vary by specialist.

We recommend asking the hospital for Informed Financial Consent before any admission. This provides an estimate of potential out of pocket costs, so you can make an informed decision.

Yes. As a Bupa customer, you continue to have a choice about where you receive your hospital care.

Bupa has agreements with many private hospitals and day surgeries across Australia, including those within our Member’s First hospital network, which are designed to help provide more certainty around out of pocket hospital costs, in line with your policy.

If this change affects your plans, you can use Bupa’s Find a Provider tool to explore alternative hospitals and specialists available to you, or contact us and we can help talk through your options and next steps.

If you have questions or would like help understanding your options, we’re here to support you. You can:

  • speak with your treating doctor or the hospital for care specific information
  • contact Bupa to talk through your cover, options, or next steps