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I-Clarity Hub - Knowledge Base - Processing English eGOS4 Claims

Processing English eGOS4 Claims

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I-Clarity Version: i-Clarity
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This describes a possible process for completing eGOS4 claims in i-Clarity. It is broken down into five parts.

Part 1: The dispense or sale

Part 2: The initial patient signature

Part 3: The repair information

Part 4: The patient receive signature

Part 5: Supplier signature and submission

Please note, before submitting your first eGOS4 claim on i-Clarity, you will need to update the PCSE schemeas in your system.

To do this, open the Maintenance module. On the first tab 'Passwords/Backup', click the button 'Update Claim Schemas'.

Part 1: The Dispense or Sale

GOS 4 claims are tracked through i-Clarity on the deferred payments module using the payment type ‘NHS Repair’.

Therefore, your replacement pair or repair should have an NHS repair payment type used against it for the electronic claim and payment to link.

You can do this in the following ways:

1. Complete a dispense and select a repair option from the voucher drop down on the dispense.

 

When you confirm the dispense and close, an automatic payment of type NHS repair will have been used against the sale.

2. Complete a dispense without assigning a repair option from the voucher drop down. After confirming the dispense and clicking close the patient account will open. Enter a payment against the sale using the payment type NHS Repair.

3. Create a sale for the repair on the patient account and then use the NHS Repair payment type button as above to add a payment against this sale.

Part 2: The Initial Patient Signature

Click on the 'Px Claims' button.

Then click on the 'GOS4' tab at thetop left of the claim page.

New claims are coloured green, if you need to start a new claim click on the new button at the top of the page.

The patient name, date of birth and address will be pulled through from the main patient record to the claim.

Double check the patient eligibility is selected.

If the patient is under 16, then the 'Patient is aged under 16' will be automatically ticked. The automatic selection of any other reason relies on the main record being completed.

Select if the spectacles are being Repaired or Replaced.

Once you have selected repair or replace a box will appear for an explanation reason.

Once you have completed the explanation click the ‘Hide’ button.

The last eye exam date will be automatically completed automatically by i-Clarity where possible. This field can be completed or edited manually if required.

The most recent spectacle prescription on the patient record will be entered onto the claim automatically.

To add the initial patient signature, click on the add patient signature under the patient details column.

This will enter today’s date in the signature date field and will open the signature box for the patient to sign.

Once the patient has signed in the black out lined box click the ‘Save’ button under the signature box.

Complete the parent/carer/guardian’s name and address if required.

If applicable you can now, click the 'Exit' button at the top of the page to close the claim page.

Part 3: The Repair Information

The repair information is in the 3rd column on the claim.

Next complete the values of the repair.

If applicable, enter the amount being claimed for any supplements.

If completing a replacement, ensure the 'Voucher value plus supplements' field is completed.

If completing a repair, ensure the parts plus supplements field is completed.

Then click on the 'Link Payment' button.

This will open new box called ‘Unlinked Payments’. It will show any sale dates that have an NHS repair payment used against them and the amount of the NHS repair payment.

This will enter the sale amount into the Retail Cost field and the NHS repair payment amount into the Total Claim field.

If there is a patient contribution, then amend the values as applicable.

Click the ‘Save’ button at the top of the page and then, if applicable, click the ‘Exit’ button to close the Claims page.

Part 4: The Patient Receive Signature

When the patient has collected the repaired spectacles, open the Claims module and navigate to the GOS4 tab.

Click on the 'Receive' button.

This will open a new box with space for the patient/parent/guardian’s signature and also the parent/guardian’s name (and address is applicable).

The signature date field will automatically be completed with today’s date.

Once completed, click the ‘Save’ button at the bottom of the box.

If applicable you can now, ‘Click’ the exit button to close the claim page.

Part 5: Supplier Signature and Submission

To add a supplier signature to the claim, click on the authorise signature box.

This will open a password pop up box.

Enter your i-Clarity password.

This will enter your name into the supplier signature name fields and today’s date into the supplier signature date field and open a signature box.

Enter your signature in the black outlined box and click the save button at the bottom left of the box.

If validation error box has disappeared, you can now double check your claims information has been completed correctly and click on the 'Submit' button to submit the claim to the PCSE website.

If the validation errors button is still visible you can click on this box to see a list of items that still need to be completed on this claim.

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