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Ophthalmic provider assurance

Provider Assurance delivers a national, regional and local service that supports and facilitates the effective and consistent management of primary care services. 

We work on behalf of NHS England on the following tasks:

  • annual GOS complaints
  • GOS 4 pre-authorisation
  • post-payment verification (PPV)

Annual general ophthalmic services (GOS) complaints

Under GOS regulations 2008, contractors are required to submit an annual form that shows the number of written complaints received in their practice.

If contractors have not received any complaints a ‘zero return’ is required.

GOS complaints - April 2019 briefing (PDF: 72KB)

If you have any questions, contact our provider assurance team by:
Email: nhsbsa.ophthalmicproviderassurance@nhs.net
Telephone: 0300 330 9403
(Lines are open 8am to 4.30pm, Monday to Friday)

GOS 4 pre-authorisation 

We must authorise all claims for GOS 4 repair or replacement vouchers.

Adults with a qualifying health condition are entitled to a GOS 4 if they have damaged or lost their glasses.

To get authorisation, GOS contractors should call us before carrying out any repair or providing replacement glasses.

Contractors should contact our provider assurance team by telephone on 0300 330 9403.
(Lines are open 8am to 4.30pm, Monday to Friday).

Pre-authorisation of adult GOS 4 claims - national briefing (September 2018) (PDF: 115KB)Pre-authorisation of adult GOS 4 claims - November update (PDF: 170KB)

PPV documents

We're due to complete the national rollout of PPV before June 2020.

Through PPV, a sample of GOS contractors will need to submit evidence to support their payment claims.

Contractors are obliged to keep on-going, full and accurate records under their GOS contracts.

Our provider assurance team are clinically led and guided by the ‘eye health policy book’ and GOS regulations.

There are 3 outcomes as a result of PPV. These are:

  • all claims verified with no observations to feedback to the contractor
  • claims verified and contractors advised on best practice due to observations made
  • claims not verified and case escalated ​​​​​​

Ophthalmic provider assurance national briefing (PDF: 317KB)Contractors perspective process map (PDF: 119KB)Ophthalmic provider assurance Wessex area briefing (PDF: 283KB)Ophthalmic provider assurance West Yorkshire and Harrogate area briefing (PDF: 283KB)