The Recognised Skin Surveillance Services (recognised services) consist of skin surveillance for skin cancer detection, which incorporates:

1. skin checking and mole mapping
2. the examination of skin lesions and nevi utilising a dermatoscope
3. the taking, storing, and mapping of diagnostic quality images of lesions and skin to allow comparison over time
4. referral of images taken of suspicious skin lesions and nevi for diagnosis and/or further investigation by a General Medical Practitioner or Dermatologist.

Recognised services exclude services which can be claimed in part or full through a third-party source (e.g. Medicare).

The Bupa recognised provider must be in private practice, which means operating on an independent and self-supporting basis either as a sole trader, partnership, corporate or group practice but not subsidised by another party such as any type of publicly funded facility for the provision of accommodation, facilities or other services or practitioners. A person who provides treatment at a public hospital or any other type of publicly funded facility is not in private practice.

Bupa recognised providers must meet the following minimum qualifications and experience.

They must either:

• Hold current, full AHPRA registration. Student registration is not sufficient. Providers must not be suspended or de-recognised by AHPRA and must not have any AHPRA imposed conditions, undertakings, or reprimands.

Or

• Hold a bachelor's degree in Dermal Science, having completed a four-year full-time course, or equivalent.

And

• Have a minimum of 60 hours of practical experience in Dermatoscopy

And

• Have undertaken additional, Bupa approved, specialised training (see below) and maintain accreditation and experience with ongoing maintenance of Continuing Professional Development or a certain level of lesion identification volume per annum as determined by the relevant Corporate Provider.

Bupa approved specialised training includes the following courses delivered by the relevant Australian based Registered Training Organisation (RTO). Both these RTOs and their courses are indicative only and may be amended from time to time:

Demonstrating equivalence

Where Clinicians delivering the Recognised Skin Surveillance Services to Bupa health insurance customers have not completed a Bupa approved course of study, they may have their qualifications and experience assessed at one of the education providers above to demonstrate equivalence through recognition of prior learning assessment.

1. Bupa may use its absolute discretion in granting Bupa provider recognition. Meeting the criteria above does not guarantee that Bupa will provide such recognition.
2. Bupa reserves the right to audit Bupa recognised providers to ensure ongoing compliance with this recognition criteria, and on request (giving at least 14 days' notice) requires reasonable access to records to validate compliance with this recognition criteria and/or to validate claims. Bupa audit requests may be made by letter, email or telephone and audits may be undertaken by Bupa or a Bupa authorised representative.
3. Bupa recognised providers that, in Bupa's reasonable opinion, do not comply with the recognition criteria or the Ancillary Provider Terms, or who have not provided Bupa access to audit, or requested audit records, within 14 days of receipt of an audit request, may have their status as a Bupa recognised provider immediately suspended or terminated. Notification of suspension or termination will be provided in most instances to the Bupa recognised provider. Bupa may also suspend or terminate registration as a Bupa recognised provider where there have been no customer claims processed by Bupa for a period of two (2) or more years.
4. Bupa will not pay, and will not accept claims for, benefits in respect of services provided by:
   (a) a Clinician when Bupa has suspended or terminated that Clinician's status as a Bupa recognised provider (such that they become a 'deregistered Clinician');
   (b) any Clinician at a clinic at which a deregistered clinician continues to provide the services to Bupa health insurance customers.
5. Where Bupa suspends or terminates registration as a Bupa recognised provider, Bupa may also in its sole discretion advise Bupa health insurance customers who have previously claimed in respect of Recognised Skin Surveillance Services previously provided by the relevant Clinician.
6. If a Clinician seeks to be re-registered with Bupa as a Bupa recognised provider following a suspension or termination, the Corporate Provider must send their request in writing to Bupa for approval in its discretion.
7. A Clinician may choose to cease participating as a Bupa recognised provider at any time by providing 30 days' notice to Bupa through the Corporate Provider.

Bupa will publish any changes to this recognition criteria on its website.