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Ophthalmic provider assurance

Due to coronavirus (COVID-19), our phone lines for ophthalmic services are temporarily unavailable

If you need to contact us, we're available to support by email between 8am and 4pm. You can email us at: nhsbsa.paos@nhs.net

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
  • GOS4 pre-authorisation
  • post-payment verification (PPV)

Due to coronavirus (COVID-19), our phone lines for Ophthalmic Services are temporarily unavailable. If you need to contact us, we're available to support by email between 8am and 4pm. You can email us using: nhsbsa.paos@nhs.net.

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.

The 2018/19 GOS complaints submission is now closed. The information collected will be shared with the relevant NHS England regional teams and they will contact contractors if necessary.

GOS complaints - April 2019 briefing (PDF: 103KB)

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 4pm, Monday to Friday.

Find out about call charges

GOS4 pre-authorisation 

We must authorise all claims for GOS4 repair or replacement vouchers.

Ophthalmic contractors are required to seek pre-authorisation from us for all GOS4 claims. Patients are entitled to a GOS4 if they have damaged or lost their glasses and they are: 

  • aged 16 or over 

  • in receipt of a particular benefit 

  • have a qualifying health condition 

 Patients aged 16 to 17 and in support of local care do not need pre-approval. 

 

You should contact us before carrying out any repair or providing replacement glasses. If patients contact us directly, they will be directed back to the appropriate contractor. 

 

To get authorisation, you should email our provider assurance team at nhsbsa.paos@nhs.net. You should include: 

  • your ODS code (will be in format TPXXXX) 
  • patient’s date of birth 
  • patient’s unique practice patient ID (there’s no need to include the name of the patient) 
  • if the patient is in receipt of any benefits to confirm their eligibility for GOS4 
  • medical reason for the GOS4 claim 
  • date of most recent sight test
  • date of most recent spectacle dispense
  • date of when next sight test is due
  • reason for recall of sight test (if earlier than 2 years)

Prior to authorising the GOS4, under instruction from the Optometric Fees Negotiating Committee, we will ask you some questions about the claim. 

 

Once we’ve received the information from you, we will assess your claim as quickly as possible. 

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)

NHSmail

If you're a GOS contractor, NHSmail is a safe and secure way to communicate with us. 

To get an NHSmail account, complete our online form. This process can take up to two weeks.

GOS contract applications proof of concept for the London and South East regions

We are delivering a proof of concept for contract administration which involves the processing of:

  • GOS contract applications
  • GOS contract terminations
  • GOS contract variations

Our proof of concept is only applicable to contractors based in the London and South East (Kent, Surrey, Sussex, Oxfordshire, Berkshire, Buckinghamshire, Hampshire and the Isle of Wight) regions. 

Application forms and guidance are available to download from the GOS contract applications page.

Find out more information in our briefing documents:GOS contract briefing document for contractors based in London (Word: 60KB)GOS contract briefing document for contractors based in the South East region (PDF: 128KB)

Ophthalmic Bulletin

If you would like to receive our bulletin by email, complete the Ophthalmic Bulletin request form and we'll add you to the distribution list.