GOS Claims

GOS Claims

Claiming for GOS fees and vouchers differs in each UK Country. Further information is provided for each country below.

Additional information on ensuring accurate claims is also provided below.

GOS Claims – England

Since 2016 Capita has provided Primary Care Support England (PCSE) services for NHS England, including

  • GOS claims
  • GOS form provision
  • CET payments
  • Performers List applications

The PCSE website provides contact details and states where GOS claims should be sent.

Any contractor with concerns regarding payment can contact Capita via email, [email protected], or via phone 0333 014 2884.  For further information on GOS claims, including Hot Briefs, please contact FODO.

GOS Payment Directions 2013 – England

The regulations stipulating the payment of GOS claims, eligibility and payment criteria are below.

GOS Forms and Clarification of GOS Procedures – England

The guidance below (FPN 713) clarifies GOS Procedures and GOS form completion.

Redemption of Optical Vouchers

Since 2008 PCTs/Area Teams have had the power to ensure all voucher claims are valid whether from contractors or non-contractors meaning all suppliers are subject to the same scrutiny.

Optical Confederation Position on Over- and Under-Claiming GOS Fees in England

The link below provides the Optical Confederations position on Over- and Under-Claiming GOS Fees in England.

GOS Claims Wales

Further details on GOS Claims in Wales including cut off dates can be found on the Welsh Primary Care Services website.

Post Payment Verification – Wales

BSC Wales protocol and guidance for Post Payment Verification of GOS Claims (November 2006).

Your local Regional Optical Committee (ROC) can provide a buddy or mentor for contractors who have a PPV visit to ensure fairness and speedy resolution of any queries from the PPV Team. To access the contact details of the ROC please visit www.optometrywales.org.uk

GOS Claims Scotland

GOS Claims – Practitioner Services

e-GOS has already been implemented in Scotland.  Information on GOS Claims, including e-GOS and submission, is located on the Practitioner Services website.

GOS Payment Regulations – Scotland

The regulations stipulating the payment of GOS claims, eligibility and payment criteria are outlined in the GOS payment directions below.

GOS Claims Northern Ireland

GOS claims (in paper form) should be submitted to the Business Services Organisation (BSO) by the 10th of each month. Electronic claim submission is via OCS and must occur by the 21st of each month to be included in that month’s payment. Further information is available on the BSO website and via the GOS memorandum below.

Making Accurate Claims

In order to claim for GOS sight tests and GOS vouchers in England the relevant GOS forms (GOS 1 for sight tests, GOS 3 optical appliances, GOS 4 repair and replacement, GOS 5 help with the cost of a private sight test and GOS 6 domiciliary) must be completed in full.  Evidence of entitlement must be provided (or the evidence not seen box ticked) and if the sight test was conducted earlier then the recommend recall interval the early retest code should be included.  Signatures of the performer and patient should also be recorded where specified.

Guidance on making accurate claims and providing General Ophthalmic Services (GOS) in England, Wales, Scotland and Northern Ireland is available to download via the links below.