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BUPA CLAIM ONLINE PROCEDURE: BUPA ONLINE SERVICES


CLAIMING
STEP-BY-STEP GUIDE TO MAKING A CLAIM

STEP 1: VISIT YOUR GP
The process generally starts with a visit to your GP. Your GP will advise you if you need to see a consultant or healthcare professional.

STEP 2: GET A REFERRAL FOR YOUR TREATMENT: CHECK WHICH OPTION APPLIES TO YOUR COVER
If you need to see a consultant, your GP will provide you with a referral letter which will detail the type of specialist your GP would like you to see. There are some conditions where a GP referral is not normally required and details of these are available from bupa online services on request. For information on these conditions please call member services or go to bupa.co.uk/policyinformation. The list of conditions for which a GP referral is not usually required may be updated from time to time. Check the ‘Cover option’ within the Group Details section of your membership certificate to see whether the Open Referral Service applies to your cover. If your ‘Cover option’ does not state open referral, then it does not apply to you.

If the Open Referral Service does not apply to you: Bupa nevertheless recommend that you ask for an ‘open referral’ which will detail the care your GP would like you to have, but will not be addressed to a specific consultant, hospital or healthcare professional. An open referral needs to include your GP’s assessment of your symptoms, the body area affected and medical speciality required. By obtaining an open referral Bupa can offer you a choice of consultants, as well as help you to make sure you avoid any extra costs (some consultants charge fees which are outside bupa benefit limits and if they do, you may need to pay some of the fees). You’ll find a simple open referral form for your GP to complete on: bupa.co.uk/referral If your GP does want to provide online services you with a referral to a specific consultant make sure you confirm with bupa that they charge within benefit limits, to avoid being responsible for any unforeseen costs.

Bupa Online Services - Claim Options


If the Open Referral Service applies to you: If the Open Referral Service applies to you, you must obtain an open referral from your GP to ensure that your treatment is covered, and to avoid having to return to your GP and obtain an open referral.

 IMPORTANT: You must call bupa to pre-authorise any claim before arranging or receiving any treatment. Failure to obtain pre-authorisation means that you will be responsible for paying for all such treatment. Bupa will help you find a consultant or healthcare professional within your local area and confirm the benefits available to you under your cover. You’ll find a simple open referral form for your GP to complete on: bupa.co.uk/referral.

STEP 3: CALL BUPA
Call bupa so that you can discuss your options and explain which consultants and healthcare professionals are covered under your Bupa membership. Bupa  will let you know what you need to do next and send you any necessary pre-treatment forms you may need to complete. Remember – if the Open Referral Service applies to you, you must call us before arranging or receiving any treatment.

Bupa Online Service- Online Health Insurance Claim 


STEP 4: GET A PRE-AUTHORISATION NUMBER
When bupa have confirmed that your treatment is covered, bupa will discuss your claim with you and issue you a ‘pre-authorisation’ number. You can then contact your consultant or healthcare provider to arrange an appointment. Bupa recommend you give your pre-authorisation number to the consultant or healthcare professional you see so that the invoice for any treatment costs can be sent to bupa directly. If your company has selected the Open Referral Service, then you must call bupa to pre-authorise your treatment. If for any reason you are sent an invoice, simply send it on to: Claims Department, Bupa, Salford Quays, M50 3XL. Once bupa have made payment, bupa will send you a summary of your claim and treatment details. Please note that payment may take a number of weeks depending on how quickly invoices are submitted to bupa.

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