What is the Bupa Australia Medical Gap Scheme?

Bupa Australia believes that the care a patient receives is of utmost importance and that part of that care is reducing or eliminating the financial expenses that may be caused by medical gaps.

Bupa Australia’s Medical Gap Scheme reduces or eliminates the medical gap paid by your patients when they are hospitalised. It provides a no or known gap cover and allows the practitioner to participate in the Scheme on an episode by episode basis.

It makes the process simple for you and your patients – saving you time, reducing your paperwork and reducing bad debts. Plus, at Bupa Australia we utilise an electronic system called Eclipse, which makes claims processing fast and easy.

Eclipse enables your medical gap claims to be lodged electronically. Eclipse is a secure information processing system that uses the internet to communicate between Medicare Australia, health funds and Medical Practitioners.

For Practitioners

For Patients

You can use the Medical Gap Scheme on a case by case basis;
Potential for increased practice volume as members seek a no or known gap experience;
One full payment to you representing both the Medicare and Bupa Australia benefit;
No need to pursue unpaid accounts from Bupa Australia members;
Administratively simpler - one payment deposited to your nominated bank account;
Available for all MBS in-patient services at all licensed hospitals and day surgeries;
Potential for increased patient satisfaction as care is delivered without financial concerns;
A weekly statement detailing all payments will be available via our secure website.

Financial certainty of no or known medical gap for in-patient services;
Patients continue to have their choice of medical practitioner;
Simplified billing process - no need for patients to claim through a number of sources;
Potential for improved value perception of private healthcare, further supporting the private system.

For Bupa Australia

Covering the in-patient medical gap;
Potential for increased member satisfaction and value;
Aiming to enhance relationships with healthcare professionals

Why should I join the Bupa Australia Medical Gap Scheme?

Why should I use Eclipse?

How to register yourself or your practice to use the Bupa Australia Medical Gap Scheme?

Please read and understand the Terms and Conditions applicable to the Bupa Australia Medical Gap Scheme
Complete the Bupa Australia Medical Gap Scheme Online Application form (formerly known as a Direct Credit Authority Form). Alternatively, you can download a .pdf version of this application by clicking here to submit via Fax or Post as below.
Finally, fax or email us a copy of a bank deposit slip, cancelled cheque or bank statement to authorise and verify your account details.

Fax: 03 9937 4419 or Email: eprovops@Bupa.com.au

Please quote the reference number allocated when submitting online.

Bupa Australia Provider Operations
Reply Paid 14639
Melbourne VIC 3001

What’s the next step:

You will be sent a Bupa Australia Medical Gap Scheme Welcome Kit in the post. This kit contains your Practice ID number (required for claiming with Bupa Australia and through Eclipse); Medical Gap Scheme stationery including Batch Header forms and Doctor Account forms as well as a Stationery re-order form
Please brief your staff on requirements and benefits of the Bupa Australia Medical Gap Scheme;
Inform your patients of the benefits of the Bupa Australia Medical Gap Scheme for them
Start using the Bupa Australia Medical Gap scheme!

How to use the Bupa Australia Medical Gap Scheme

Check patient Eligibility – please call 131 243
Submit your accounts or Doctor Account forms together with a completed Batch Header to Bupa Australia or electronically via Eclipse
Reconcile your accounts. One consolidated report that will cover all Bupa Australia brands will be mailed to your postal address.
Contact Bupa Australia with any queries you might have.