Q. I am already a Bupa recognised provider, why is Bupa asking me to join a network?

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1 30 APRIL 2014 Bupa Audiology Networks Q&A Bupa Network Q. I am already a Bupa recognised provider, why is Bupa asking me to join a network? A. We want our customers s to have easy access to quality and fee assured audiology services close to where they live. To help us do this, we are building a nationwide network of recognised Audiologists, which will help us ensure that Bupa customers have access to high-quality treatment as quickly and as easily as possible, in line with clinical best practice. It also enables us to assure our customers that they will be treated by an audiologist who offers treatment at the levels of quality they expect and whose rates are fair and reasonable. Once established, only audiologists who are members of the new network will be eligible to receive Bupa funding for treatment provided to our customers. Audiologists who choose not to apply to join the network will not be recognised by Bupa for any new treatments and will be unable to receive reimbursement from Bupa for treating any Bupa customers. Q. How will Bupa decide whether my application is successful? A. Successful applicants will be those whose qualifications and experience meet our network criteria, and whose fees are fair and reasonable when compared to those charged by other audiologists in their region. Q. Is this just another way to reduce professional fees? A. No. Clinicians are increasingly being required to demonstrate the effectiveness of what they do in terms of clinical outcomes and cost across health services in the UK. We have a responsibility to our customers to ensure that the rates we pay healthcare professionals are fair and reasonable. To ensure that we do this we benchmark clinicians fees against recent claims and make external comparisons. Q. If Bupa does not agree to my rates, can I charge my Bupa insured patients directly? A. No. Our customers tell us that they want all their healthcare costs to be paid directly by Bupa, to enable them to concentrate on feeling better. All Bupa network clinicians agree not to send Bupa customers bills for any top up fees. Q. How will I benefit from joining the Bupa Audiology Network? A. Joining the network gives you certainty about what and when we will pay you. We will also promote your practice to our customers on our online directory of therapists, consultants and facilities, which attracts 20,000 unique visitors every week. 1 Bupa Audiology Networks Q&A 30 April 2014

2 Q. Has Bupa consulted with any professional bodies about the network? A. As part of our planning for the network, we spoke with the British Academy of Audiology. We are keen to continue to work with providers and their professional bodies, so that we can assure quality, deliver an improved experience and drive better value for our customers. Q. Will Bupa guarantee me a certain number of patients? A. Bupa cannot guarantee volume of patients but if your application is successful you will be recognised to provide services to Bupa customers and will be able to promote your practice on Finder - our online directory of therapists, consultants, and facilities, which attracts 20,000 unique visitors every week. Q. How often will Bupa review fees? A. We will review the fees that we pay network Audiologists on an on-going basis taking into account changes in treatment practice, customer feedback and changes in economy. The application process Q. How can I apply to join the Bupa Audiology Network? Please visit where you will find all the information you need to apply to join the network. Q. How does Bupa intend to use the information submitted during the application process? A. We will use the information to update our records and support our ongoing relationship with you. We will treat this information as confidential. The application form explains which information may be shared with Bupa customers, on a Bupa website and through other media. You have the opportunity to accept or decline this as you complete your application. Q. What information will Bupa share with customers? A. If you join the Bupa Audiology Network we will share the following information with Bupa customers: your name and qualifications, your specialty/sub-specialty, and your contact details. We will check with you before sharing any other information about you with our customers. Q. Do I still need to complete an application if I belong to a practice? 2 Bupa Audiology Networks Q&A 30 April 2014

3 A. The application process is for individual audiologists. Providers wishing to be reimbursed for treating Bupa customers must submit their own application to join the network, even if they work within a group or practice. Q. I work from two sites, my own practice and the local private hospital. The hospital manages the billing when I treat patients there, do I need to include these rates in my agreement? No, you only need to include the rates you will be invoicing Bupa for directly. If we have an agreement for your services with a hospital, these rates will not be included as part of your personal agreement with Bupa. Q. I work at a hospital and invoice Bupa for diagnostic tests and treatment. The hospital invoice for the hire of the room and equipment, will Bupa fund both the hospital and the clinician? No, Bupa agrees fees with recognised facilities (whether hospitals, clinics or laboratories) that include fees for diagnostic tests. Where such arrangements are in place, Bupa (or the relevant Member) is not liable to reimburse you for these services as they are provided and paid for under that contract with the recognised facility. You must contact the facility directly for reimbursement of your fees for these services Q. Do I have to bill electronically? A. Yes. You can do this by using our new free e-billing facility which allows you to submit your invoices to Bupa simply and securely online, with no need to register. You can also use most practice management software systems For more information please go to Q. If Bupa does not offer me an agreement, will you tell me why? A. Yes, we will write to you explaining why we have not offered you an agreement, and you can discuss this with Bupa s Provider Management Team on *. Q. If I am unsuccessful, will I be able to apply again in the future? A. If you apply before and are unsuccessful you will be able to address the reasons for your application being unsuccessful and apply again. 3 Bupa Audiology Networks Q&A 30 April 2014

4 Quality and service Q. How will Bupa measure the quality of the service I provide? A. We want to ensure our customers receive the high quality of treatment and service that they expect. This is why we ask network audiologists to meet key quality criteria, including regularly sending Bupa information about the quality of treatment and their practice as outlined in section three of the network terms and conditions. Q. Does the Bupa Audiology Network restrict patient choice? A. No. We will work to ensure that our customers have a wide choice of Bupa Audiology network providers locally. The network gives our customers the assurance that they will be treated by a clinician who offers treatment at the level of quality and value for money that they expect. Q. Is Bupa trying to restrict the number of providers in the network? A. No. Any providers who agree to the standard network terms and fees are eligible to join the network. There is no limit on the number of providers in the network. Q. Is Bupa acting as a regulator by having professional criteria? A. No. Our professional network recognition criteria are based on standards set by the professional bodies. Q. What is Bupa s approach to clinical guidelines? A. We use published, evidence-based, guidelines and systematic reviews developed by recognised organisations, such as the National Institute for Health and Care Excellence (NICE), the Health and Care Professions Council, the relevant Colleges and the Cochrane Collaboration Institute, to inform our approach to care pathways. Where there is a lack of evidence and/or a lack of clarity about the most appropriate care, we consult the relevant professional organisations or independent experts for their views. We also commission independent reviews of the evidence from organisations who are specialists in evidence-based medicine such as Bazian. Q. What is a DBS check? A. The organisation formerly known as the Criminal Records Bureau (CRB) is now called the Disclosure and Barring Service (DBS), so CRB checks are now called DBS checks. More information can be found here 4 Bupa Audiology Networks Q&A 30 April 2014

5 Contacting Bupa Q. I ve got more questions, who can I contact? Please us at: ProvMgtConsultants@bupa.com or call our Provider Management Team on * * Lines are open between 8am and 6pm Monday to Friday. Calls to this number may be recorded and may be monitored. Calls are charged at local rates. 5 Bupa Audiology Networks Q&A 30 April 2014