ADF claims through the BUPA Defence Contract

ADF claims through the BUPA Defence Contract

From July 2019, BUPA has assumed management of healthcare services for Australian Defence Force personnel. Previously this was managed by Medibank Health Solutions.

 

In Cutting Edge select the ADF fee schedules. The fund and schedule details are already set up for you.

  

Registration and invoicing methods


Invoices for defence personnel can be submitted using Bupa's online gateway, iRBS, or by email to adfhscproviders@bupa.com.au

 

Details are available at the links below. 

 

Bupa ADF Provider Network

Bupa iRBS How To Guide

Terms & Conditions

 

All providers who are currently registered with BUPA will have received an email with a link inviting them to register as an 'ADFrecognized provider' and to become part of the Provider Network. Once registered, providers will have access to the IRBS Portal (Intelligent Referral Booking System) where all claims can be lodged. Invoices created in Cutting Edge can be uploaded as a PDF via the portal. Claims will then be processed and paid within 10 days (expected) and providers notified of payments via the portal. The payments can then be entered into Cutting Edge like any standard manual payment. Note that there is no online Eclipse-like system to manage claims directly.

 

Providers DO NOT have to register to be part of the ADF provider network in order to be paid and they will not be penalized as such. If they choose not to register they will not have access to the IRBS, but can still make a manual claim via fax (03 9937 3010) or mail (ADF, Central Support Team, 33 Exhibition Street, Melbourne, VIC, 3000). There is no need for a batch header as long as all details are on the invoice. BUPA Payee IDs need to be documented on the invoice and this is done automatically in CE. Manual claims processing time is expected to be approximately 4 weeks.

  

Note: Patients who are members of the health fund 'Defence Health' are not part of the above scheme, and are covered under the AHSA group.

 


    • Related Articles

    • Adding your Online Claiming Details for BUPA and HBF

      BUPA It's important to put your correct BUPA Schedule Type and Payee ID on the Settings/Online screen. You will not be able to transmit claims to BUPA funds until you do.   Most providers should use the full BUPA schedule. BUPA pays some providers at ...
    • Adding your Online Claiming Details for BUPA and HBF

      BUPA It is important to have the correct BUPA Schedule Type and Payee ID entered on the Settings/Online screen.  Claims to Bupa will not process if transmitted without the Bupa ID.  You also need to update the Bupa Payee ID for each facility/hospital ...
    • Dealing with Part Paid claims

      From time to time electronic claims may only be paid in part. The Invoice Status will be Part Paid, so you can easily locate them on the Part Paid tab in the Invoices listing page. The resolution depends on the cause of the part payment. Here are ...
    • Types of Online Claims

      The Health Fund you've selected on an invoice will dictate which claim type (Medicare, DVA or Private Health) is used. This also sets the Fee Calculation to the correct value. Bulk Bill Claims Electronic Bulk Bill claims allow you to claim the MBS ...
    • Dealing with Rejected Claims

      From time to time electronic claims will be rejected. In this case they will appear on the Rejected Claims tab on the ECLIPSE page.  The Invoice Status will also get changed to Follow Up, so you can easily locate rejected claims on the Follow Up tab ...