GOS1 Form PDF Details

In the realm of healthcare and optical services within the NHS, the GOS1 form plays a pivotal role in streamlining the process of claiming for NHS sight tests, including both standard and mobile services. With the advent of electronic submissions, it's crucial for Primary Care Organisations (PCOs) and optical stores to familiarize themselves with the start-up requirements, which involve providing specific codes and agreeing to link by signing a form. This process encourages a cohesive approach before initiating electronic claims. Additionally, understanding the timing for starting claims, the choice between electronic or traditional manual submissions, and the recommended manual approval period for claims is essential. The guidance doesn't stop at the initial setup; there's comprehensive support available through a dedicated website, offering a user guide and further information to address common queries and enhance the submission process. The form addresses various procedural nuances, such as data formatting, validation checks, and the handling of claims with special circumstances like early retests or multiple reasons for entitlement. It's made clear that accurate data entry, especially concerning patient and practitioner details, is crucial for the smooth processing of claims. Notably, the system implements a range of automatic checks to ensure the integrity of submitted claims, which underscores the importance of adherence to guidelines and the provision of complete and accurate information. This interconnected system of requirements, guidance, and checks underscores the complexity and precision needed in the submission of GOS1 claims, aiming to facilitate a seamless operation for the benefit of both service providers and recipients.

QuestionAnswer
Form NameGOS1 Form
Form Length1 pages
Fillable?Yes
Fillable fields1
Avg. time to fill out27 sec
Other namesgos form, nhs gos1, gos1 mobile, form gos1 no download needed

Form Preview Example

ELECTRONIC LINKS OF GOS1 (NHS SIGHT TESTS) and GOS6 (MOBILE NHS SIGHT TESTS)

FREQUENTLY ASKED QUESTIONS FOR NEW SITES

1.WHAT ARE THE START UP REQUIREMENTS?

PCOs must provide Health & Social Care Information Centre with the local payment code and uniform list number of the relevant store by raising a support log in the usual manner. The code and ULN should be collected on an ‘Agreement to Link form’, available to download from the Electronic Links on-line Help screen. It is recommended that PCOs and stores meet before going live to discuss and agree the process and sign the Agreement to Link form, but first check that the store is running practice software which supports links. Specsavers, Ocuco-Relcon (for Vision Express and Healthcall), Optix & Opticabase have practice systems accredited for electronic submission.

2.WHEN CAN I START?

At any time during an open payment cycle.

3.CAN I MIX LINKED WITH TRADITIONAL MANUALLY INPUT CLAIMS?

Yes, this will be for local agreement between the PCO and store depending upon the success or otherwise of the initial electronic submissions.

4.SHOULD I SWITCH ON AUTOMATIC PROCESSING IMMEDIATELY?

No. It is recommended that manual approval of individual claims be undertaken for approximately two weeks to help stores and PCOs identify and correct potential issues, some of which are outlined below.

5.WHERE CAN I FIND THE USER GUIDE? There is a dedicated web site at: https://nww.openexeter.nhs.uk/nhsia/opthelp/Ophthalmics/eng/indexElectronic.html Here you can find a specific electronic links user guide and other relevant information.

6.I CANNOT SEE DATE OF LAST SIGHT TEST OR SUPPLEMENTARY LIST NO. ON A CLAIM THAT HAS PASSED VALIDATION BY EXETER?

Although this is preprinted on many forms, this data is not mandatory and may not be submitted to the payments system. However, the payment system will check the date of the claim against the actual date of a previous claim recorded in the system, comparing these with the acceptable frequency for a sight test set out in the Memorandum of Understanding between the Department of Health and the Profession. The system will reject a claim which transgresses the Memorandum of Understanding unless a clinical reason code has been supplied.

7.CAN I SEE WHICH CLAIMS HAVE BEEN REJECTED DURING VALIDATION?

No. The store will receive an error message highlighting the reason for the rejection but there is no facility within the payments system for this to be viewed.

8. CAN STORES SUBMIT CLAIMS IN UPPER AND/OR LOWER CASE?

Any format is acceptable, however it is recommended that stores enter data in upper case. This makes sorting by patient name more effective and audit letters better presented.

9.WILL THE SYSTEM ACCEPT EARLY RETESTS WITHOUT AN APPROPRIATE CODE?

It may, but not if a previous claim exists in the system with a date which transgresses the Memorandum of Understanding between the Department of Health and the Profession.

10.WHAT HAPPENS TO CLAIMS WHEN MULTIPLE REASONS FOR ENTITLEMENT TO AN NHS SIGHT TEST HAS BEEN ENTERED?

Although not required, many stores also enter the reason for entitlement to a GOS 3 on the GOS1 claim. Both reasons will need to pass validation although only one will appear in the “REASON” field. The system will reject income support for patients over 60 and stores should be reminded of the need to enter pension credit for these claims.

11.SHOULD STORES ENTER GP/HOSPITAL DETAILS FOR PATIENTS WITH DIABETES/GLAUCOMA?

Yes, this information is pulled through into the payments system it is also subject to validation and relevant claims will be rejected without this information. For the GP/Hospital details (and also for school/college details for students) a supplementary address is required, e.g., Town, District etc.

12.IS THERE INCONSISTENCY IN THE TREATMENT OF EVIDENCE NOT SEEN?

The Specsavers computer system has a field for “Evidence Seen”. This has a default setting of YES. Specsavers stores must be reminded to change that default when the Evidence Not Seen roundel is ticked on the form.

13.THE UNIFORM LIST NUMBER IS WRONG, WHAT SHOULD I DO?

You can’t change a Practitioner’s Uniform List Number in the system because this can only be done by the Ophthalmic Payment team at NHSCFH. Raise a support log via the normal National Support desk, 01392 251289.

You will be required to provide the full current Uniform List Number and name of the Practitioner involved and the full Uniform List Number that you wish it to be.

14.WHAT VALIDATION CHECKS ARE AUTOMATICALY COMPLETED ON AN ELECTRONICALLY SUMITTED GOS CLAIM?

a.General checks applied to all GOS claim types:-

Rejection

Description

Condition

Code

 

 

1

Record Status is invalid

The record status field has not been

 

 

set as REQUESTED

2

Version is missing or is invalid

The version field is missing or is an

 

 

invalid value

3

Currency is missing or is invalid

The currency field is missing or is an

 

 

invalid value

4

Record type is missing or is

The record type field is missing or is

 

invalid

an invalid value

5

Date of file creation is missing

The date of file creation field is

 

or is invalid

missing or is an invalid date or is in

 

 

the future

6

Time of file creation is missing

The time of file creation field is

 

or is invalid

missing or is an invalid time

7

Responsible organisation is

The responsible organisation code

 

missing or is unknown

field is missing or is unknown to the

 

 

central ophthalmic payments system

8

Batch reference or record

The submitting organisation batch

 

reference number are too big

reference or record reference

 

 

number are too big

9

Invalid Title

The patient’s title field is an invalid

 

 

value

10

Surname is missing

The patient’s surname field is

 

 

missing or is an invalid value

11

Forenames is missing

The patient’s forenames field is

 

 

missing or is an invalid value

12

Address line is missing

The patient’s address detail is

 

 

missing or is an invalid value

13

Postcode is missing

The patient’s postcode field is

 

 

missing or is an invalid value

14

Patient’s date of birth is

The patient’s date of birth field is

 

missing, is invalid or is in the

missing, is an invalid date or is a

 

future

date in the future

 

 

 

15

Date of last sight test,

The date of the last sight test or

 

prescription is an invalid value

prescription field is an invalid value

 

or before patient’s date of birth

 

 

 

 

16

NHS reason is missing or is

The patient’s NHS reason field is

 

invalid

missing or contains an invalid value

 

 

 

17

Evidence not seen is missing

The evidence not seen field is

 

 

missing

18

Who signed is missing or is

The who signed field is missing or is

 

invalid

an invalid value

 

 

 

19

Payment account code is

The payment account code is

 

missing or is invalid

missing or is an invalid value

 

 

 

20

Local practitioner code is

The local practitioner code field is

 

 

missing or is an unknown value to

 

missing or is invalid

the central ophthalmic payments

 

 

system

21

Practitioner’s uniform list

The practitioner’s uniform list

 

number is missing, is unknown

number field is missing, is not

 

to the central ophthalmic

registered on the practitioner list

 

payments system or is an

within the specified responsible

 

invalid format

organisation or is an invalid format

 

 

 

22

Date of claim is missing, is

The date of claim field is missing, is

 

invalid or is in the future

invalid, is a date before the service

 

 

date or is a date in the future

23

Record end is missing or is

The record end field is missing or

 

invalid

not set to REND

 

 

 

24

Practitioner is no longer active

The practitioner identified by the

 

on the responsible NHS

practitioner list number is no longer

 

organisations practitioner list

active on the responsible NHS

 

and the date of the GOS

organisation practitioner list and the

 

service is after their date off list

date of the GOS service is after their

 

 

date off list

25

Practitioner is yet to be

The practitioner identified by the

 

activated onto the responsible

practitioner list number is yet to be

 

NHS organisations practitioner

activated on the responsible NHS

 

list and the date of the GOS

organisation practitioner list and the

 

service is before their date on

date of the GOS service is before

 

list

their date on list

 

 

 

26

Patient reason is Over 60 and

The NHS patient reason field has

 

the patient was not 60 or over

been set to Over 60 and the patient

 

when the GOS service was

was not 60 or over when the GOS

 

performed

service was performed by the

 

 

practitioner

27

Patient reason is Under 16 and

The NHS patient reason field has

 

the patient was not under 16

been set to Under 16 and the patient

 

when the GOS service was

was not under 16 when the GOS

 

performed

service was performed by the

 

 

practitioner

28

Patient reason is HC2 and the

The NHS patient reason field has

 

certificate number has not been

been set to HC2 and the certificate

 

supplied when the evidence not

number field has not been supplied

 

seen field is set to No

when the evidence not seen field

 

 

has been set to No

29

Patient reason is HC3 and the

The NHS patient reason field has

 

certificate number has not been

been set to HC3 and the certificate

 

supplied when the evidence not

number field has not been supplied

 

seen field is set to No

when the evidence not seen field

 

 

has been set to No

30

Patient reason is Student and

The NHS patient reason field has

 

the patient was not aged

been set to Student and the patient

 

between 16 and 18 when the

was not aged 16, 17 or 18 when the

 

GOS service was performed

GOS service was performed by the

 

 

practitioner

31

GOS service date is before 1st

No GOS fees are available within

 

April 1995, no known payment

the central ophthalmic payments

 

fee

system for any GOS claims where

 

 

the service date is before 1st April

 

 

1995

32

Supplementary Name is

The supplementary name field

 

missing

should contain a value when the

 

 

NHS reason has been set to

 

 

student, diabetic, glaucoma,

 

 

glaucoma risk, blind or prisoner on

 

 

leave

 

 

See section GOS Claim Notes for

 

 

further information on the

 

 

supplementary name

33

Supplementary Town is

The supplementary town field should

 

missing

contain a value when the NHS

 

 

reason has been set to student,

 

 

diabetic, glaucoma or glaucoma risk

 

 

See section GOS Claim Notes for

 

 

further information on the

 

 

supplementary town

 

 

 

34

Date of GOS service is before

The GOS service date is before the

 

patent’s date of birth

patient’s date of birth

 

 

 

35

Beneficiary’s date of birth is

The beneficiary’s date of birth is an

 

invalid or is in the future

invalid date or is in the future

 

 

 

36

Possible Duplicate claim

This is a possible duplicate claim.

 

 

See Appendix C for GOS Sight Test

 

 

Intervals

37

NHS Number to large

The patient’s NHS Number is to

 

 

large

38

NI Number to large

The patient’s NI Number is to large

 

 

 

39

Beneficiary NHS Number to

The beneficiary’s NHS Number is to

 

large

large

 

 

 

40

Beneficiary NI Number to large

The beneficiary’s NI Number is to

 

 

large

41

NHS Sight Test fee to large

Sight Test fee is too large or is a

 

 

negative number

42

National Code to large

National Code is too large

 

 

 

43

NHS Domiciliary fee to large

Domiciliary fee is too large or is a

 

 

negative number

44

Total GOS Claim value to large

Total claim value is too large or is a

 

 

negative number

45

Beneficiary name to large

The beneficiary’s name is to large

 

 

 

46

Patient reason is Income

The NHS patient reason field has

 

Support and patient not aged

been set to Income Support and the

 

between 16 and the National

patient was not aged between 16

 

Retirement age when the GOS

and National Retirement age when

 

service was performed

the GOS service was performed by

 

 

the practitioner. Refer to Appendix

 

 

E for further information on benefit

 

 

age regulations

47

Patient reason is Pension

The NHS patient reason field has

 

Credit and patient not reached

been set to Pension Credit and the

 

the State Pension age when

patient had not reached the State

 

the GOS service was

Pension age when the GOS service

 

performed

was performed by the practitioner.

 

 

Refer to Appendix E for further

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