Bupa Facility Recognition Application form





Thank you for your interest in becoming a Bupa recognised facility. Before starting your application, please read the information below.
Please review the Healthcare Services Agreement and our Business Rules, which are the standard rules referred to in the HSA and which apply to all Bupa recognised facilities.

Business rules  (PDF, 2.9MB)

Healthcare Services Agreement for NHS provider  (PDF, 0.4MB)

Healthcare Services Agreement for non NHS provider  (PDF, 0.3MB)

Important

Please be aware that we’re not under any obligation to recognise a facility, and the recognition of a facility will always be subject to the agreement between us of written terms and conditions relating to that facility. The facility won’t be eligible to treat Bupa members until this agreement is in place. Completion of this application doesn’t automatically grant recognition status.
As you may expect, we won’t process any application where we consider the applicant to have directly or indirectly obtained confidential information from any member of staff or representative of Bupa.

Confidentiality

We’ll only use the information that you submit to us as part of this process for the purposes of this application.


Preparation

Before you begin completing your application, we’ve included the following notes to help you

Provider Details
   
  • Please provide the organisational details and contact information
  • All mandatory questions within this section are marked with an asterisk (*)

     
Facilities

  • Please tell us what facilities and equipment are available at each location.
  • Facilities will require an additional core quality assessment to be completed. This can be completed here.
      
Specialties

  • Please tell us what specialties can be treated at each location.
  • Certain facilities and equipment will require an additional quality assessment to be completed.  Where this is required it is denoted by an asterisk ). We will contact you following receipt of your application if this applies.

     
Schedule of Procedures

  • The procedures listed are charged to Bupa as fully inclusive Fixed Price Packages (with the exception of Consultant fees and Prosthesis costs which may be charged in addition). For further information, please refer to the Services and Charges Rules.
  • Please select each procedure that can be performed at each location.
  • Please add the price you charge and your service code for each procedure.
  • This section lists any surgical procedures which have a surgical classification.
  • All the codes listed are from the Bupa Schedule of Procedures and are based upon the CCSD schedule.
  • You can filter by each section of the Bupa Schedule of Procedures and by sub-section.
  • If you perform any procedures that cannot be found in the schedule, please add the code and description to the end of the list.
  • This section includes any diagnostic scopes, for example, flexible sigmoidoscopy
  • Procedures marked with a … form part of a specialist network agreement which falls outside of the standard agreement / recognition process. Please inform us if you perform these procedures and we can send you the relevant application to complete.

     
Schedule of Diagnostic Tests

  • Please select each diagnostic test which can be performed at each location
  • Please add the price you charge and your service code for each test.
  • The price you quote within this schedule should be fully inclusive of all recording and reporting, interpretation, consumables and equipment costs where applicable.

     
Schedule of Therapies

  • Please select each therapy that can be performed at each location
  • Please add the price you charge and your service code for each therapy session.
  • If you perform any therapies that cannot be found in the schedule, please add the code, description and price to the end of the list.

     
Consultant Details

  • Please provide the name, GMC number and specialty for the consultant(s) who work from your locations.
  • All mandatory questions within this section are marked with an asterisk (*).


Billing and Payment

  • Please confirm the requirements as specified.


Next steps

We’ll review your application and, so long as it meets the criteria, we'll send you a secure email offering you Bupa recognition and explaining the next steps. To finalise your application and accept our offer, you'll need to reply to this email. 


If you need anything at all in the meantime please feel free to contact us at facilityrecognition@bupa.com


Confidentiality agreement
We’ll only use the information you have submitted to us as part of this process for the purposes of this application, and in our ongoing relationship in the event that you join as a Bupa recognised facility. To view our privacy notice, which governs customer information, please visit www.bupa.co.uk/privacy.

We’ll share information that is commercially sensitive with you during the application process and we reserve all copyright, intellectual property rights and other rights of ownership to that information. Any information shared between us for the purposes of this application will also be in commercial confidence.

*Lines are open between 8am and 4pm, Monday to Friday. We may record or monitor our calls.

 
 

1. Are you an independent Hospital/Clinic?



1. Is the facility(s) registered with Care Quality Commission, Healthcare Inspectorate Wales, Health Improvement Scotland, The Regulation and Quality Improvement Authority (Northern Ireland) or equivalent registration by another regulator? *







Section One: Billing and Payment
2. Please confirm that you are able to submit 100% of your invoices electronically,either via Healthcode or Bupa’s Provider’s online system



3. Please confirm that you are able to accept payment by BACS.



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