GOS1 Form – Fill Out and Use This PDF

The GOS1 form is a crucial document for optical stores within the UK's National Health Service (NHS), facilitating the electronic submission of NHS sight test claims. This process streamlines the linkage between primary care organizations (PCOs) and stores, ensuring efficient and accurate claim handling for both traditional and mobile NHS sight tests. For new sites looking to start, key startup requirements include providing specific codes and agreeing on the process with PCOs. To simplify your journey with the GOS1 and GOS6 forms, click the button below to fill out your form today.

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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.

Question	Answer
Form Name	GOS1 Form
Form Length	1 pages
Fillable?	Yes
Fillable fields	1
Avg. time to fill out	27 sec
Other names	gos form, nhs gos1, gos1 mobile, form gos1 no download needed

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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

		information on benefit age
		regulations
48	Patient reason is Tax Credit	The NHS patient reason field has
	and patient not aged 16 or over	been set to Tax Credit and the
	when the GOS service was	patient was not 16 or over when the
	performed	GOS service was performed by the
		practitioner
49	Patient reason is Job Seekers	The NHS patient reason field has
	Allowance and patient is not	been set to JSA and the patient was
	aged between 16 and the	not aged between 16 and the
	National Retirement age when	National Retirement age when the
	the GOS service was	GOS service was performed by the
	performed	practitioner. Refer to Appendix E for
		further information on benefit age
		regulations
50	Patient reason is 40+ &	The NHS patient reason field has
	glaucoma relative and patient	been set to 40+ & glaucoma relative
	age was not over 40 when the	and the patient was not aged over
	GOS service was performed	40 when the GOS service was
		performed by the practitioner
51	A previously accepted GOS	An accepted claim has been deleted
	claim record has now been	from the central ophthalmic
	manually rejected	payments system by the responsible
		paying organisation and will not be
		paid. No rejection text will be
		available under this rejection code,
		but the reason is usually concerning
		an incomplete paper GOS form
52	Any other reason for rejection	There is some other reason why this
		claim has been rejected
53	Patient reason is Prisoner on	The NHS patient reason field has
	Leave from Prison and patient	been set to Prisoner on Leave from
	not aged 16 or over when the	Prison and the patient was not aged
	GOS service was performed	16 or over when the GOS service
		was performed by the practitioner
54	Patient reason is Employment	The NHS patient reason field has
	and Support Allowance (ESA)	been set to Employment and
	and patient not aged between	Support Allowance (ESA) and the
	16 and the National Retirement	patient was not aged between 16
	age when the GOS service was	and National Retirement age when
	performed	the GOS service was performed by
		the practitioner. Refer to Appendix
		E for further information on benefit
		age regulations
55	Duplicate claim(s) have been	Duplicate claim(s) have been found
	found within the same	within the same submission
	submission

b.GOS 1 checks:-

Rejection	Description	Condition
Code
1000	Incorrect number of elements	The number of elements found
	found within the GOS 1 claim	within the GOS 1 claim record does
	record	not match the expected number for
		the specified version
1001	Date of sight test is missing, is	The date of sight test field is
	invalid or is in the future	missing, is an invalid date, is at most
		6 months ago or is in the future
1002	Referred to GP is invalid	The referred to GP field is not set to
		Yes or No
1003	No prescription is invalid	The no prescription field is not set to
		Yes or No
1004	Unchanged prescription is invalid	The unchanged prescription field is
		not set to Yes or No
1005	No change is invalid	The no change field is not set to Yes
		or No
1006	New prescription issued is	The new prescription issued field is
	invalid	not set to Yes or No

1007	No prescription and new	The no prescription and new
	prescription issued are both set	prescription issues have both been
	to Yes	set to Yes

1008	Voucher Issued is invalid	The voucher issued field is not set to
		Yes or No
1009	Voucher code 1 is invalid	The voucher code 1 field has been
		set to an invalid voucher code.
		Valid voucher codes for the patient’s
		first pair of glasses are:
		A, B, C, D, E, F, G, H, CC or CF
		If no voucher code is required, for
		the patient’s first pair of glasses, this
		field can be set to blank
1010	Voucher code 2 is invalid	The voucher code 2 field has been
		set to an invalid voucher code.
		Valid voucher codes for the patient’s
		second pair of glasses are:
		A, B, C, D, or CC
		If no voucher code is required, for
		the patient’s second pair of glasses,
		this field can be set to blank
1011	Voucher issued has been set to	The voucher issued field has been
	yes and voucher code 1 has no	set to yes and the voucher code 1
	voucher code	field has no voucher code

1012	Supplementary type 1 is invalid	The supplementary type 1 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or any combination, like CPT
		If no supplements are required on
		the patients first pair of glasses, then

		this field can be set to blank
1013	Supplementary type 2 is invalid	The supplementary type 2 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or any combination, like CPT
		If no supplements are required on
		the patients second pair of glasses,
		then this field can be set to blank
1014	Supplement type 1 or	If the patient requires a complex
	supplement type 2 has been	supplement for their prescription, the
	set to C and the NHS patient	NHS reason must be set to complex
	reason has not been set to	and supplement type 1 or
	Complex or visa versa	supplement type 2 must have a C
		present
1015	Reason for earlier sight test is	The reason for earlier sight test field
	invalid	has been set to an invalid re-test
		code
1016	Pre-reg performed the sight	The pre-reg performed this sight test
	test is invalid	field has not been set to Yes or No

1017	Supplementary uniform list	The supplementary uniform list
	number is unknown to the	number does not currently exist
	central ophthalmic payments	within the central ophthalmic
	system or is an invalid format	payment system or is an invalid
		format
1018	Assistant uniform list number is	The assistant uniform list number
	unknown to the central	does not currently exist within the
	ophthalmic payments system or	central ophthalmic payment system
	is an invalid format	or is an invalid format

1019	Supplementary uniform list	Only one optician is able to perform
	number and assistant uniform	this sight test, so both of these can
	list number both supplied	not be known

c.GOS 3 checks:-

Rejection	Description	Condition
Code
3000	Incorrect number of elements	The number of elements found
	found within the GOS 3 claim	within the GOS 3 claim record does
	record	not match the expected number for
		the specified version
3001	Voucher code 1 is missing or	The voucher code 1 field is missing
	is invalid	or has been set to an invalid voucher
		code.
		Valid voucher codes for the patient’s
		first pair of glasses are:
		A, B, C, D, E, F, G, H, CC or CF
3002	Voucher code 2 is missing or	The voucher code 2 field has been
	is invalid	set to an invalid voucher code.
		Valid voucher codes for the patient’s
		second pair of glasses are:
		A, B, C, D, or CC
		If no voucher code is required, for
		the patient’s second pair of glasses,
		this field can be set to blank
3003	Supplementary type 1 is invalid	The supplementary type 1 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or S or any combination, like
		CPTS
		If no supplements are required on
		the patients first pair of glasses, then
		this field can be set to blank
3004	Supplementary type 2 is invalid	The supplementary type 2 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or S or any combination, like
		CPTS
		If no supplements are required on
		the patients second pair of glasses,
		then this field can be set to blank
3005	Supplement type 1 or	If the patient requires a complex
	supplement type 2 has been	supplement for their prescription, the
	set to C and the NHS patient	NHS reason must be set to complex
	reason has not been set to	and supplement type 1 or
	Complex or visa versa	supplement type 2 must have a C
		present
3006	Right prescription values are	Some or all of the values supplied
	invalid	for the right prescription are not
		numerical values
3007	Left prescription values are	Some or all of the values supplied
	invalid	for the left prescription are not

		numerical values
3008	Prescription values and issued	The patient’s prescription values are
	voucher code(s) are incorrect	not associated to the voucher
		code(s) dispensed
3009	Code of the NHS Organisation	Code of the NHS Organisation
	receiving relevant sight test is	receiving relevant sight test is an
	missing or invalid	invalid value

3010	The practitioner’s uniform list	The practitioner’s uniform list
	number, who performed the	number, who performed the sight
	sight test, is missing or is	test, is missing or is an invalid value
	invalid

3011	The date of sight test is	The date of sight test is missing, is
	missing, is invalid or is in the	an invalid date or is a date in the
	future	future

3012	Patient’s contribution value is	The patient’s contribution value is
	invalid	not a numerical value, is a negative
		number, is larger than £99.99 or is
		missing when the patient reason is
		HC3
3013	The date ordered is missing, is	The date ordered is missing, is
	invalid or is in the future	invalid, is at most 2 years ago or is
		in the future
3014	Glasses or contacts supplied is	Glasses or contact lenses dispensed
	missing or is invalid	by the supplier is missing or is an
		invalid value
3015	New or changed prescription is	The new or changed prescription
	invalid	field is not set to Yes or No

3016	Unchanged prescription but	The unchanged prescription but
	wear and tear is invalid	wear and tear is not set to Yes or No

3017	New or changed prescription	The new or changed prescription
	and unchanged prescription but	and unchanged prescription but
	wear and tear are both set to	wear and tear fields are both set to
	Yes	Yes

3018	Retail price for 1st pair is invalid	The retail price value for the 1st pair
		is not a numerical value or is a
		negative number
3019	Retail price for 2nd pair is invalid	The retail price value for the 2nd pair
		is not a numerical value or is a
		negative number
3020	Voucher value for the 1st pair is	The voucher value for the 1st pair is
	invalid	not a numerical value or is a
		negative number
3021	Voucher value for the 2nd pair is	The voucher value for the 2nd pair is
	invalid	not a numerical value or is a
		negative number
3022	Complex value for 1st pair is	The complex value for the 1st pair is
	invalid	not a numerical value or is a
		negative number
3023	Complex value for 2nd pair is	The complex value for the 2nd pair is
	invalid	not a numerical value or is a
		negative number
3024	Supplementary values for the	Some or all of the values supplied
		for the 1st pair supplementary costs

	1st pair are invalid	are not numerical values or are
		negative numbers
3025	Supplementary values for the	Some or all of the values supplied
	2nd pair are invalid	for the 2nd pair supplementary costs
		are not numerical values or are
		negative numbers
3026	Prism supplement code for 1st	The prism supplement code for the
	pair is invalid	1st pair is invalid due to the 1st pair
		voucher code or is missing when the
		prism supplement for 1st pair is set
		to Yes
3027	Prism value for the 1st pair is	The prism value for the 1st pair is not
	invalid	a numerical value or is a negative
		number
3028	Prism supplement code for 2nd	The prism supplement code for the
	pair is invalid	2nd pair is invalid due to the 2nd pair
		voucher code or is missing when the
		prism supplement for 2nd pair is set
		to Yes
3029	Prism value for the 2nd pair is	The prism value for the 2nd pair is
	invalid	not a numerical value or is a
		negative number
3030	Tint supplement code for 1st	The tint supplement code for the 1st
	pair is invalid	pair is invalid due to the 1st pair
		voucher code or is missing when the
		tint supplement for 1st pair is set to
		Yes
3031	Tint value for the 1st pair is	The tint value for the 1st pair is not a
	invalid	numerical value or is a negative
		number
3032	Tint supplement code for 2nd	The tint supplement code for the 2nd
	pair is invalid	pair is invalid due to the 2nd pair
		voucher code or is missing when the
		tint supplement for 2nd pair is set to
		Yes
3033	Tint value for the 2nd pair is	The tint value for the 2nd pair is not a
	invalid	numerical value or is a negative
		number
3034	Small glasses supplement code	The small glasses supplement code
	for 1st pair is invalid	for the 1st pair is invalid due to the 1st
		pair voucher code or is missing
		when the small glasses supplement
		for 1st pair is set to Yes or the patient
		is over 7 years old
3035	Small glasses supplement	The small glasses value for the 1st
	value for the 1st pair is invalid	pair is not a numerical value or is a
		negative number
3036	1st pair boxed centre distance is	The 1st pair boxed centre distance
	invalid	field is larger than the 55 millimetres,
		is not a numerical field or is a
		negative number when patient
		supplied with a small glasses
		supplement
3037	Small glasses supplement code	The small glasses supplement code
	for 2nd pair is invalid	for the 2nd pair is invalid due to the

		2nd pair voucher code or is missing
		when the small glasses supplement
		for 2nd pair is set to Yes or the
		patient is over 7 years old
3038	Small glasses supplement	The small glasses value for the 2nd
	value for the 2nd pair is invalid	pair is not a numerical value or is a
		negative number
3039	2nd pair boxed centre distance	The 2nd pair boxed centre distance
	is invalid	field is larger than the 55 millimetres,
		is not a numerical field or is a
		negative number when patient
		supplied with a small glasses
		supplement
3040	Photo chromic supplement	The photo chromic supplement code
	code for 1st pair is invalid	for the 1st pair is invalid due to the 1st
		pair voucher code or is missing
		when the photo chromic supplement
		for 1st pair is set to Yes.
		This is only valid on an HES claim
3041	Photo chromic supplement	The photo chromic value for the 1st
	value for the 1st pair is invalid	pair is not a numerical value or is a
		negative number
3042	Photo chromic supplement	The photo chromic supplement code
	code for 2nd pair is invalid	for the 2nd pair is invalid due to the
		2nd pair voucher code or is missing
		when the photo chromic supplement
		for 2nd pair is set to Yes.
		This is only valid on an HES claim
3043	Photo chromic supplement	The photo chromic value for the 2nd
	value for the 2nd pair is invalid	pair is not a numerical value or is a
		negative number
3044	Facial supplement for 1st pair is	The facial supplement field for the
	invalid	1st pair is not set to Yes or No.
		This is only valid on an HES claim
3045	Facial supplement value for the	The facial value for the 1st pair is not
	1st pair is invalid	a numerical value or is a negative
		number
3046	Facial supplement for 2nd pair is	The facial supplement field for the
	invalid	2nd pair is not set to Yes or No.
		This is only valid on an HES claim
3047	Facial supplement value for the	The facial value for the 2nd pair is not
	2nd pair is invalid	a numerical value or is a negative
		number
3048	Voucher and supplements	The voucher and supplements value
	value for 1st pair is invalid	for the 1st pair is not a numerical
		value or is a negative number
3049	Voucher and supplements	The voucher and supplements value
	value for 2nd pair is invalid	for the 2nd pair is not a numerical
		value or is a negative number
3050	Maximum amount is invalid	The maximum amount field is not a
		numerical value or is a negative
		number
3051	Total amount payable is invalid	The total amount payable field is not
		a numerical value or is a negative
		number

3052	Supply date for 1st pair is	The supply date field for the 1st pair
	invalid	is missing, is an invalid date, is
		before date ordered or is a date in
		the future
3053	Supply date for 2nd pair is	The supply date field for the 2nd pair
	invalid	is an invalid date, is before date
		ordered or is a date in the future
3054	Number of glasses or contact	The number of glasses or contact
	lenses supplied is invalid	lenses supplied is missing or not set
		as 0, 1 or 2.
		Use 0 if Uncollected = Yes
3055	Date collected is invalid	The date collected is missing, is an
		invalid date, is at most 2 years ago,
		is more than 2 years after date
		ordered or is a date in the future
		when Uncollected is No
3056	Uncollected Glasses	The uncollected glasses field is an
		invalid value
3057	Who signed 2 is invalid	The who signed 2 field is missing or
		is an invalid value
3058	Patient declaration date is	The patient declaration date is an
	invalid	invalid date or is a date in the future
		when Uncollected is No

d.GOS 4 checks:-

Rejection	Description	Condition
Code
4000	Incorrect number of elements	The number of elements found
	found within the GOS 4 claim	within the GOS 4 claim record does
	record	not match the expected number for
		the specified version
4001	Patient’s contribution value is	The patient’s contribution value is
	invalid	not a numerical value, is a negative
		number, is larger than £99.99 or is
		missing when the patient reason is
		HC3
4002	Loss or damage indicator is	The loss or damage indicator is
	invalid	missing or is an invalid value when
		the NHS Reason is not set as under
		16
4003	Loss or damage reason is	The loss or damage reason is too
	invalid	large or is not a valid code when the
		NHS Reason is not set as under 16
4004	Date ordered is invalid	The date ordered field is missing, is
		an invalid date, is at most 2 years
		ago or is a date in the future
4005	Patient repaired or replaced is	The patient repaired or replaced is
	invalid	missing or is an invalid value

4006	Who signed 2 is invalid	The who signed 2 fields is missing or
		is an invalid value
4007	Date collected is invalid	The date collected is missing, is an
		invalid date, is at most 2 years ago,
		is more than 2 years after date
		ordered or is a date in the future
		when Uncollected is No
4008	Uncollected Glasses	The uncollected glasses field is an
		invalid value
4009	Repaired glasses	The repaired glasses field is missing
		or is an invalid value
4010	Replaced glasses/contact	The replaced glasses /contact
	lenses	lenses field is missing or is an invalid
		value
4011	Repaired glasses and replaced	The repaired glasses and replaced
	glasses/contact lenses are both	glasses/contact lenses fields are
	set to Yes or No	both set to Yes or No

4012	Right prescription values are	Some or all of the values supplied
	invalid	for the right prescription are not
		numerical values when replacing a
		voucher or repairing lenses
4013	Left prescription values are	Some or all of the values supplied
	invalid	for the left prescription are not
		numerical values when replacing a
		voucher or repairing lenses
4014	Prescription values and issued	The patient’s prescription values are
	voucher code(s) are incorrect	not associated to the voucher

		code(s) dispensed.
4015	Voucher code is missing or is	The voucher code field has been set
	invalid	to an invalid voucher code. If
		replaced glasses/contact lenses =
		Yes
		Valid voucher codes for the patient’s
		first pair of glasses are:
		A, B, C, D, E, F, G, H, CC or CF
4016	Supplementary type is invalid	The supplementary type field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or S or any combination, like
		CPTS
		If no supplements are required on
		the patients first pair of glasses, then
		this field can be set to blank
4017	Voucher Value is invalid	The voucher value field is not a
		numerical value or is a negative
		number. If replaced glasses/contact
		lenses = Yes
4018	Right lens repaired is invalid	The right lens repaired field is not
		set to Yes or No. If repaired glasses
		= Yes
4019	Left lens repaired is invalid	The left lens repaired field is not set
		to Yes or No. If repaired glasses =
		Yes
4020	Both lenses repaired is invalid	The both lenses repaired field is not
		set to Yes or No. If repaired glasses
		= Yes
4021	Repaired lens code is invalid	The repaired lens code is incorrect
		or is an invalid value. If repaired
		glasses = Yes
4022	Repair lens value is invalid	The repair lens value field is not a
		numerical value or is a negative
		number. If repaired glasses = Yes
4023	Front frame repaired is invalid	The front frame repaired field is not
		set to Yes or No. If repaired glasses
		= Yes
4024	Side frame repaired is invalid	The side frame repaired field is not
		set to Yes or No. If repaired glasses
		= Yes
4025	Whole frame repaired is invalid	The whole frame repaired field is not
		set to Yes or No. If repaired glasses
		= Yes
4026	Repair frame code is invalid	The repair frame repaired code is
		incorrect or is an invalid value. If
		repaired glasses = Yes
4027	Repair frame value is invalid	The repair frame value field is not a
		numerical value or is a negative
		number. If repaired glasses = Yes
4028	Supplement type 1 or	If the patient requires a complex
	supplement type 2 has been	supplement for their prescription, the
	set to C and the NHS patient	NHS reason must be set to complex
	reason has not been set to	and supplement type 1 or

	Complex or visa versa	supplement type 2 must have a C
		present
4029	Complex value is invalid	The complex value field is not a
		numerical value or is a negative
		number
4030	Prism supplement code is	The prism supplement code is
	invalid	incorrect or is an invalid value

4031	Prism value is invalid	The prism value field is not a
		numerical value or is a negative
		number
4032	Tint supplement code is invalid	The tint supplement code is incorrect
		or is an invalid value
4033	Tint value is invalid	The tint value field is not a numerical
		value or is a negative number
4034	Repair small glasses	The repair small glasses supplement
	supplement code is invalid	code is incorrect or is an invalid
		value. If repaired glasses = Yes
4035	Repair small glasses value is	The repair small glasses value field
	invalid	is not a numerical value or is a
		negative number. If repaired glasses
		= Yes
4036	Replacement small glasses	The replacement small glasses
	supplement code is invalid	supplement code is incorrect or is an
		invalid value. If replaced/glasses
		contact lenses = Yes
4037	Replacement small glasses	The replacement small glasses
	value is invalid	value field is not a numerical value
		or is a negative number. If
		replaced/glasses contact lenses =
		Yes
4038	Voucher and supplements total	The voucher and supplements total
	value is invalid	value field is not a numerical value
		or is a negative number
4039	Parts and supplements total	The parts and supplements total
	value is invalid	value field is not a numerical value
		or is a negative number
4040	Voucher and supplements total	The voucher and supplements total
	value and parts and	value and parts and supplements
	supplements total value are	total value fields have both been set
	invalid	to a value. A GOS4 claim can only
		be a repair or a replacement
4041	The GOS 4 claim is invalid	The voucher code and lens code or
		frame code have both been set to a
		value. A GOS4 claim can only be a
		repair or a replacement
4042	Retail price is invalid	The retail price field is not a
		numerical value or is a negative
		number
4043	Total claim is invalid	The total claim field is not a
		numerical value or is a negative
		number
4044	Patient repaired or replaced	The patient declaration of service
	and practitioner repaired	does not match the practitioner’s
	glasses or replaced	declaration of service
	glasses/contact lenses are

	invalid

4045	The fields right lens repaired,	These fields fail the GOS
	left lens repaired and both	regulations. Only one should be set
	lenses repaired are invalid	to Yes as appropriate for the lens
		repair
4046	The fields Frame front repaired,	These fields fail the GOS
	frame side repaired and frame	regulations. Only one should be set
	whole repaired are invalid	to Yes as appropriate for the frame
		repair

e.GOS 5 checks:-

Rejection	Description	Condition
Code
5000	Incorrect number of elements	The number of elements found
	found within the GOS 5 claim	within the GOS 5 claim record does
	record	not match the expected number for
		the specified version
5001	Date of sight test is missing, is	The date of sight test field is
	invalid or is in the future	missing, is an invalid date, is at most
		6 months ago or is in the future
5002	Referred to GP is invalid	The referred to GP field is not set to
		Yes or No
5003	No prescription is invalid	The no prescription field is not set to
		Yes or No
5004	Unchanged prescription is	The unchanged prescription field is
	invalid	not set to Yes or No
5005	No change is invalid	The no change field is not set to Yes
		or No
5006	New prescription issued is	The new prescription issued field is
	invalid	not set to Yes or No

5007	No prescription and new	The no prescription and new
	prescription issued are both set	prescription issues have both been
	to Yes	set to Yes

5008	Voucher issued is invalid	The voucher issued field is not set to
		Yes or No
5009	Voucher code 1 is invalid	The voucher code 1 field has been
		set to an invalid voucher code.
		Valid voucher codes for the patient’s
		first pair of glasses are:
		A, B, C, D, E, F, G, H, CC or CF
		If no voucher code is required, for
		the patient’s first pair of glasses, this
		field can be set to blank
5010	Voucher code 2 is invalid	The voucher code 2 field has been
		set to an invalid voucher code.
		Valid voucher codes for the patient’s
		second pair of glasses are:
		A, B, C, D, or CC
		If no voucher code is required, for
		the patient’s second pair of glasses,
		this field can be set to blank
5011	Voucher issued has been set to	The voucher issued field has been
	yes and voucher code 1 has no	set to yes and the voucher code 1
	voucher code	field has no voucher code

5012	Supplementary type 1 is invalid	The supplementary type 1 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or any combination, like CPT
		If no supplements are required on

		the patients first pair of glasses, then
		this field can be set to blank
5013	Supplementary type 2 is invalid	The supplementary type 2 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or any combination, like CPT
		If no supplements are required on
		the patients second pair of glasses,
		then this field can be set to blank
5014	Reason for earlier sight test is	The reason for earlier sight test field
	invalid	has been set to an invalid re-test
		code
5015	Pre-reg performed the sight	The pre-reg performed this sight test
	test is invalid	field has not been set to Yes or No

5016	Performer’s uniform list number	The performer uniform list number
	is unknown to the central	does not currently exist within the
	ophthalmic payments system or	central ophthalmic payment system
	is an invalid format	or is an invalid format

5017	Patient’s contribution value is	The patient’s contribution value is
	invalid	missing, is not a numerical value or
		is a negative number
5018	Domiciliary visit is invalid	The domiciliary visit field is missing
		or is an invalid value
5019	Reason for domiciliary visit is	The reason for domiciliary visit is
	invalid	invalid

5020	1st patient at address is missing	The 1st patient at address field is
	or is invalid	missing or is an invalid value

5021	2nd patient at address is	The 2nd patient at address field is
	missing or is invalid	missing or is an invalid value

5022	3rd or subsequent patient at	The 3rd or subsequent patient at
	address is missing or is invalid	address field is missing or is an
		invalid value
5023	Lower of private or NHS sight	The lower of private or NHS sight
	test fee is invalid	test fee field is not a numerical value
		or is a negative number
5024	Lower of private or NHS	The lower of private or NHS
	domiciliary fee is invalid	domiciliary fee field is not a
		numerical value or is a negative
		number
5025	Maximum claim in respect for	The maximum claim in respect of
	sight test is invalid	sight test fee field is not a numerical
		value or is a negative number
5026	Total claim value is invalid	The total claim value field is not a
		numerical value or is a negative
		number

f.GOS 6 checks:-

Rejection	Description	Condition
Code
6000	Incorrect number of elements	The number of elements found
	found within the GOS 6 claim	within the GOS 6 claim record does
	record	not match the expected number for
		the specified version
6001	Date of sight test is missing, is	The date of sight test field is
	invalid or is in the future	missing, is an invalid date, is at most
		6 months ago or is in the future
6002	Referred to GP is invalid	The referred to GP field is not set to
		Yes or No
6003	No prescription is invalid	The no prescription field is not set to
		Yes or No
6004	Unchanged prescription is	The unchanged prescription field is
	invalid	not set to Yes or No
6005	No change is invalid	The no change field is not set to Yes
		or No
6006	New prescription issued is	The new prescription issued field is
	invalid	not set to Yes or No

6007	No prescription and new	The no prescription and new
	prescription issued are both set	prescription issues have both been
	to Yes	set to Yes

6008	Voucher Issued is invalid	The voucher issued field is not set to
		Yes or No
6009	Voucher code 1 is invalid	The voucher code 1 field has been
		set to an invalid voucher code.
		Valid voucher codes for the patient’s
		first pair of glasses are:
		A, B, C, D, E, F, G, H, CC or CF
		If no voucher code is required, for
		the patient’s first pair of glasses, this
		field can be set to blank
6010	Voucher code 2 is invalid	The voucher code 2 field has been
		set to an invalid voucher code.
		Valid voucher codes for the patient’s
		second pair of glasses are:
		A, B, C, D, or CC
		If no voucher code is required, for
		the patient’s second pair of glasses,
		this field can be set to blank
6011	Voucher issued has been set to	The voucher issued field has been
	yes and voucher code 1 has no	set to yes and the voucher code 1
	voucher code	field has no voucher code

6012	Supplementary type 1 is invalid	The supplementary type 1 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or any combination, like CPT
		If no supplements are required on

		the patients first pair of glasses, then
		this field can be set to blank
6013	Supplementary type 2 is invalid	The supplementary type 2 field has
		been set to an invalid supplementary
		code.
		Valid supplementary code are:
		C, P, T or any combination, like CPT
		If no supplements are required on
		the patients second pair of glasses,
		then this field can be set to blank
6014	Supplement type 1 or	If the patient requires a complex
	supplement type 2 has been	supplement for their prescription, the
	set to C and the NHS patient	NHS reason must be set to complex
	reason has not been set to	and supplement type 1 or
	Complex or visa versa	supplement type 2 must have a C
		present
6015	Reason for earlier sight test is	The reason for earlier sight test field
	invalid	has been set to an invalid re-test
		code
6016	Pre-reg performed the sight	The pre-reg performed this sight test
	test is invalid	field has not been set to Yes or No

6017	Supplementary uniform list	The supplementary uniform list
	number is unknown to the	number does not currently exist
	central ophthalmic payments	within the central ophthalmic
	system or is an invalid format	payment system or is an invalid
		format
6018	Assistant uniform list number is	The assistant uniform list number
	unknown to the central	does not currently exist within the
	ophthalmic payments system or	central ophthalmic payment system
	is an invalid format	or is an invalid format

6019	Supplementary uniform list	Only one optician is able to perform
	number and assistant uniform	this sight test, so both of these can
	list number both supplied	not be known

6020	Reason for domiciliary visit is	The reason for the domiciliary visit
	missing	field is missing

6021	Visit to one domiciliary patient	The visit to one domiciliary patient
	is missing or is invalid	field is missing or is an invalid value

6022	Visit to several domiciliary	The visit to several domiciliary
	patients is missing or is invalid	patients field is missing or is an
		invalid value
6023	1st patient at address is missing	The 1st patient at address field is
	or is invalid	missing or is an invalid value

6024	2nd patient at address is	The 2nd patient at address field is
	missing or is invalid	missing or is an invalid value

6025	3rd or subsequent patient at	The 3rd or subsequent patient at
	address is missing or is invalid	address field is missing or is an
		invalid value

15.Why is a GOS claim rejected and returned to the practice without rejection code(s)?

An electronic GOS claim can be manually rejected by the NHS organisation and an appropriate rejection reason will be included with the rejected claim. This is usually due to the paper GOS form being incorrectly completed, e.g. missing contractor’s signature.

The paper GOS claim will be sent back to the practice for correction. The electronic claim can then be resubmitted and the corrected paper GOS form sent to the NHS organisation as normal.

16.How does the electronic validation check for possible duplicate claims?

There are two different checks performed depending on the claim type, one uses the GOS Regulations and the other will be searching for an exact matching record:

GOS Regulation check

When the early re-test code is not supplied the following check will be performed on the claim.

1.The re-test interval will be calculated based upon the NHS patient reason supplied on the claim. This is usually set as 2 years but there are some NHS reasons where the interval is set as 1 year.

2.The check allows a months grace on the interval period.

3.This date is now used to search the central ophthalmic payments system to see if any records exist for this patient from this date forward.

4.If the last claim was paid to the same optician, the claim is rejected as a possible duplicate record.

5.If the last claim was paid to a different optician, then the claim will be marked as a possible duplicate, should the claim adhere to the remaining GOS Regulations. The responsible NHS organisation can then approve or reject this claim, using the Check Possible Duplicate Electronic Claims menu option.

The claim will no longer be rejected by the validation rules and returned to their submitting practice, but will be available for you to view from this menu option, should it adhere to the remaining GOS Regulations.

When using the manual approval method, the extended duplicate check will be available to permit the operator to view all the previous claims for the patient. This information can then be used to accept this claim for payment or reject this claim as a duplicate.

Exact Matching record check

When the early re-test code has been supplied and verified to be correct the following check will be performed on the claim.

1.Using the patient details as above, a search of the central ophthalmic payments system is performed to see if any records exist for this patient. If any are found, the claim is rejected as a possible duplicate record.

Reasons for Rejection code 36 in response to Practice

Here are the reasons why this rejection code has been returned to the practice:-

1.The early re-test code has been omitted from the electronic claim.

2.The claim has been transmitted on a previous batch and has been submitted again on a new batch.

3.The patient has been seen by the practice too early, based upon their interval period.

4.The patient has seen another contractor recently and not informed the practice of this information, so the NHS sight test was completed by the practice in good faith. These claims can be viewed by using the Check Possible Duplicate Electronic Claims menu option, as detailed above.

5.A transmission batch, submitted from a Specsaver practice, of more than 150 claims has been sent for processing, and these claims are then re-sent on all further submissions until resolved by Specsavers IT support.

6.For better patient care, some practices perform a regular 6 monthly sight test on their registered children. However, the defined interval for children is currently set to one year and these claims will therefore be rejected as possible duplicates.

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