Policy

Bupa pays benefits to eligible health insurance customers for selected services delivered by Oral Health Practitioners (within their Scope of Practice as per the Dental Board of Australia) who have chosen to apply for a provider number with Medicare.

Where an Oral Health Practitioner chooses not to apply for a Medicare provider number, services they deliver can continue to be claimed using a dentist's provider number at the practice location.

Oral Health Practitioners with their own Medicare provider number at a Members First, Members First Platinum, or Members First Ultimate Dental clinic will need to be registered as a Members First, Members First Platinum, or Members First Ultimate Dental provider. This will ensure the benefits customers receive at the clinic remain the same.

Read more here: FAQs for Providers – Recognition of Oral Health Practitioners.

Bupa recognition criteria

To attain Bupa recognition as an Oral Health Practitioner, you must be in private practice^#, registered with Medicare Australia and the Australian Health Practitioner Regulation Agency (AHPRA).

Provider numbers for this category are allocated by Medicare Australia.

For recognition of new practices or alterations to addresses of current practices, call the Medicare provider enquiry line on 132 150 or visit the Services Australia website. Medicare Australia will notify us of the provider number and relevant practice information.

To become a recognised ancillary provider, each provider must agree to abide by Bupa's Ancillary Provider Terms (PDF).

Tooth ID reminder for dental claims

Just a reminder that tooth identification (tooth ID) is required for the processing of dental claims for items that relate to the treatment of a specific tooth. The tooth ID should be entered via HICAPS or HealthPoint or provided on a manual receipt against the relevant item numbers.

^#Private Practice means a health care practice operating on an independent and self-supporting basis either as a sole trader, partnership, corporate or group practice but is not subsidised by another party such as any type of publicly funded facility for the provision of accommodation, facilities or other services or practitioners. The provision of Treatment at a public hospital or any other type of publicly funded facility is not Treatment provided in Private Practice.