Bupa Endoscopy Network

Hospitals and clinics wishing to join the network will need to:

• Complete the Healthcare Services Agreement and agree to our standard prices for the network.
• Sign the Healthcare Services Agreement that we’ll send to you to confirm the services included in your hospital or clinic’s agreement with us.

Joining the network is a great way to market the services your hospital or clinic offers. Hospitals and clinics that are included in the network will have Endoscopy services displayed on their Finder profile (finder.bupa.co.uk). Finder is our online directory of healthcare professionals and services and receives over 110,000 visits a week from our customers, GPs and the general public.

Any Bupa recognised hospital or clinic providing Endoscopy services can apply to join the network as long as they have achieved Joint Advisory Group (JAG) accreditation or are registered with the Royal College of Physicians to work towards this.

Yes. If your hospital or clinic hasn’t already achieved JAG accreditation, we’ll ask you to confirm that you’ve registered with the Royal College of Physicians to work towards this. If your hospital or clinic hasn’t already registered with the Royal College you can find out more and get in touch with them at www.thejag.org.uk.

The JAG website lists the following statuses:

• Accredited: the service has undergone an accreditation assessment and has been awarded accreditation. Accredited services undergo an annual review to demonstrate that they are maintaining the standards.
• Accredited – level 1: the service meets all the accreditation standards apart from the environment and waiting times. Services have 1 year to meet these standards and move to full accreditation. This applies to services in the Republic of Ireland only.
• Deferred: the service is close to being accredited and has some actions it must take to meet the standards. It has up to 6 months to do this.
• Not awarded: the service has been assessed however wasn’t able to meet the standards. Services are able to undergo another assessment as soon as they self-declare that they meet all the standards.
• Not assessed/ undergoing assessment: the service has never had an assessment or is currently undergoing an assessment.

We renew our network every three years to make sure that we’re offering our customers access to high quality, best value services. The new agreements will run until 31 January 2028.

The network will run from 1 February 2025 to 31 January 2028.

Yes, the hospital or clinic needs to be part of the network for us to reimburse you for these services.

Diagnostic Endoscopy:

• H2002 - Diagnostic colonoscopy, includes forceps biopsy of colon and ileum
• G6500 - Diagnostic oesophago-gastro-duodenoscopy (OGD) includes forceps biopsy, biopsy urease test and dye spray
• H2502 - Diagnostic flexible sigmoidoscopy (including forceps biopsy and proctoscopy)
• G8082 - Diagnostic oesophago-gastro-duodenoscopy (OGD) and immediate colonoscopy includes forceps biopsies, biopsy test and dye spray (as sole procedure)

Therapeutic Endoscopy:

• H2003 - Therapeutic colonoscopy
• G4430 - Therapeutic oesophago-gastro-duodenoscopy (OGD)
• G8083 - Therapeutic oesophago-gastro-duodenoscopy (OGD) and immediate colonoscopy
• H2503 - Therapeutic flexible sigmoidoscopy

Capsule Endoscopy:

• G8080 - Small bowel capsule endoscopy (including interpretation and evaluation)
• G8081 – Upper GI capsule endoscopy (including interpretation and evaluation)

What codes have been added to the network?

We’re introducing three new codes (below) in line with updates from The Clinical Coding and Schedule Development (CCSD) Group.

• G8084 - Diagnostic oesophago-gastro-duodenoscopy (OGD) and immediate flexible sigmoidoscopy includes forceps biopsies, biopsy test and dye spray (as sole procedure)
• G8085 - Therapeutic oesophago-gastro-duodenoscopy (OGD) and immediate flexible sigmoidoscopy includes forceps biopsies, biopsy test and dye spray (as sole procedure)
• G8086 - Colon capsule endoscopy (including interpretation and evaluation)

Please email^{^} us at [email protected] to let us know. This means that your hospital or clinic’s existing Healthcare Services Agreement for Endoscopy Services will end on 31 January 2025 and we’ll no longer be able to reimburse it for providing Bupa patients with endoscopy services from 1 February 2025. We may make exceptions and pre-authorise on an out-of-network basis, for example to ensure continuity of care for a Bupa patient.

Yes. All hospitals and clinics need to have completed a Bupa Core Quality Assessment within the last three years to confirm that they meet the network quality criteria. We’ll be in touch separately if your hospital or clinic needs to complete the assessment.

We’ll email you a link to the Healthcare Services Agreement for Endoscopy services so you can sign it electronically, which means we can renew your hospital or clinic’s contract within two working days. You don’t need any special software and can sign the agreement securely from any computer or device. Or you can use a paper copy if you prefer. Simply print the agreement, sign it, scan it and email^{^} it back to us at [email protected]

If we’re able to include your hospital or clinic in the network, we’ll countersign the Healthcare Services Agreement and email you a link to it. If we’re unable to include your hospital or clinic in the network, we’ll write to let you know and explain the next steps.

All hospitals and clinics that meet the quality standards, agree to charge standard prices and sign up to our Healthcare Services Agreement for endoscopy services will be included in the network.

If we don’t receive your hospital or clinic’s signed agreement by 31 January 2025 your hospital or clinic’s existing Healthcare Services Agreement for Endoscopy Services will end on 31 January 2025 and we’ll no longer be able to reimburse it for providing Bupa patients with network endoscopy services from 1 February 2025. We may make exceptions and pre-authorise on an out-of-network basis, for example to ensure continuity of care for a Bupa patient. If this is case, we’ll be in touch to amend your hospital or clinic’s Healthcare Services Agreements, so endoscopy services are no longer included.

If you no longer want your hospital or clinic to be included in the network, please email^* us at [email protected] to let us know and we’ll let you know the continuity of care arrangements for any existing Bupa patients.

When Bupa patients call us to pre-authorise endoscopy services at your hospital or clinic, we’ll offer them an alternative that’s part of the Endoscopy Network. We may make exceptions and preauthorise endoscopy services on an out-of-network basis, for example to ensure continuity of care for a Bupa patient.

We’ll be in touch with you before the end of the network to let you know the next steps.

The fees for the network are set to give our customers access to quality assured endoscopy services which represent value for money. We’ve reviewed NHS tariffs and self-pay rates where available.

We’ve reviewed prices for endoscopy procedures across the private, NHS and self-pay sectors and set our fees to enable hospitals and clinics to provide these services while keeping customers’ premium increases to a minimum. As part of this review, we’ve increased the fees we pay by 4% for JAG accredited facilities and 2% for non-JAG facilities from 1 February 2025, with a further increase in years two and three to reflect inflation.

We want to encourage hospitals and clinics to achieve JAG accreditation. This is a similar approach to that taken by the NHS which has set higher tariffs for accredited hospitals and clinics for a number of years.

No. As part of joining the network, all hospitals and clinics agree to the prices which will be in place until the network renews again in 2028. However, as part of our review, we’ve increased the fees we pay by 4% for JAG accredited facilities and 2% for non-JAG facilities from 1 February 2025, with a further increase in years two and three to reflect inflation.

^{^}For more information and to sign up for a free Egress account, go to https://switch.egress.com. You will not be charged for sending secure emails to a Bupa email address using the Egress service.