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Provider Assurance (Ophthalmic) FAQs

We've compiled the answers to some of our most common questions below:

Who are the PA(O) team?

Provider Assurance (Ophthalmic) or PA(O) are part of the NHSBSA working on behalf of NHS England tasked with introducing a national standardised approach to Post-Payment Verification (PPV)

Is this compulsory

Yes, this is part of your GOS contract

Can I have an extension

If you are struggling to meet the deadline. Please contact the Provider Assurance (Ophthalmic) Team who will happily discuss extension options with you.

What are the GDPR implications for this pilot? Are you able to request patient information?

A full privacy impact assessment was carried out prior to the go-live of this pilot and all aspects of the transfer of data have been assessed in line with the impact of GDPR. The patient declaration on each type of GOS form states “I confirm I am entitled to an NHS funded sight test and I consent to the disclosure of relevant information for the purposes of checking this and in relation to the prevention and detection of fraud”.. Patients are consenting to their information being shared with NHS England and authorized organisations when they are signing the GOS form. NHSBSA has been authorized by NHS England to deliver Post Payment Verification via a memorandum of understanding between the two organizations. Therefore NHSBSA is able to access patient information for the purposes of Post Payment Verification. 

What evidence is to be supplied?

For each GOS claim, we ask that you provide evidence that confirms the validity of that claim. The following guide outlines how we will be reviewing each type of GOS form and contains with some suggestions of the evidence you might submit.

 

GOS 1 Forms:

To assess the appropriateness of a GOS 1 claim, we will be looking into the following areas:

 

  • Is there a signature from the patient/parent or guardian/carer on the GOS form?
  • Is there evidence the sight test took place?
  • Was the sight test in line with Memorandum of Understanding on minimum sight test intervals http://www.opticalconfederation.org.uk/downloads/vouchers-at-a-glance-2018-optical-confederation.pdf?

 Suggested evidence:

Please submit appropriate extracts from your sight test records for the patient, which should show as a minimum:

 

  • Patient Name
  • History and symptoms
  • Reason for the Sight Test (if it has been conducted earlier than the memorandum of Understanding on minimum sight test intervals)
  • Date of Last Sight Test

 GOS 3 Forms:

To assess the appropriateness of a GOS 3 claim, we will be looking into the following areas:

 

  • Was the change in prescription less than 0.5 dioptres on the sphere?
  • Was a complex lens supplement claimed?
  • Was a prism supplement claimed?
  • Was a Tint supplement claimed?
  • Was a small glasses supplement claimed?
  • Is there evidence that the glasses have been issued?

 Suggested evidence:

Please submit appropriate extracts from your sight test records and/or dispensing records for the patient, which should show as a minimum:

  • Appropriate extracts from the patient’s record showing Patient Prescription and any notes which relate to changes in prescription.
  • Relevant sections of the spectacle order.
  • Evidence that a glasses order has been produced.

 Please note that if you dispensed the glasses but did not carry out the sight test, you will only be required to provide evidence that the glasses have been issued.

 

GOS 4 Forms:

To assess the appropriateness of a GOS 4 claim, we will be looking into the following areas:

 

  • Has it been recorded whether the glasses have been lost or broken?
  • If the patient is over 16, is there evidence that the claim has been pre-authorised by NHS England or PCSE?
  • If the patient is over 16, is there an explanation of how the glasses were lost or broken as a direct result of illness?

 Suggested evidence: please submit appropriate extracts from your practice records for the patient, which should show as a minimum that the repair or replacement has taken place.

 

GOS 6 Forms:

To assess the appropriateness of a GOS 6 claim, we will be looking into the following areas:

 

Suggested evidence:

Please submit:

 

  • A copy of the pre visit notification if you have retained it
  • Appropriate extracts from your sight test records for the patient, which should show as a minimum:
    •  Patient Name
    •  History and symptoms
    • Reason for the Sight Test (if it has been conducted earlier than the memorandum of Understanding on minimum sight test intervals)
    • Date of Last Sight Test

How can I submit evidence?

There are a number of ways for you to submit evidence to NHSBSA. All evidence submitted must be legible. If you have access to a secure NHS Mail account you can send us your evidence by email. This can include sending screenshots of your Practice Management System or photographs/scanned copies of paper forms. To submit evidence via email, please save the electronic document with the filename (Your Practice Name/PPV reference for the sample/ Date Submitted) and email to  nhsbsa.ophthalmicproviderassurance@nhs.net  

 

If you do not have access to a secure NHS mail you will need to send your evidence via post.

If you have any questions on how to submit evidence, please contact the NHSBSA PA(O) Team on 0191 2035276.

 

Please send copies of requested evidence, along with a completed cover form which is included in Appendix B, to:

 

Provider Assurance (Ophthalmics)

NHS Business Services Authority

2nd floor

152 Pilgrim Street

Newcastle upon Tyne

NE1 6SN

 

If you are unable to provide evidence via email or post, please contact the PA(O) team on 0300 3309403 as soon as possible.