The extra service with its own rules
Many independent practices are accredited to provide locally commissioned eye services, for example urgent and minor eye condition appointments, or schemes that refine referrals before they go to the hospital. These appointments are often booked at short notice, recorded in a separate online system, and paid through a separate claims process from GOS.
In a busy practice, the service appointment is booked in the diary, the optometrist sees the patient, and the record in the scheme's system is completed later, or partly, or forgotten. At month end, the claims do not add up to the appointments, and nobody is quite sure why.
Why these services are easy to under-claim
- The service record lives in a different system from the practice's own record.
- Appointments are urgent and fitted in, so the admin afterwards is squeezed.
- Claims depend on the scheme record being complete, not on the appointment being in the diary.
- Each commissioner's scheme has its own rules and forms.
- Payment statements are checked in total rather than per appointment.
What slips through
| Stage | Common gap | What the tracker does |
|---|---|---|
| Booking | Not marked as a scheme appointment | Scheme type chosen at booking |
| After the appointment | Portal record not completed | Prompt to the optometrist the same day |
| Claim | Not submitted or incomplete | Status tracked per appointment |
| Payment | Matched only in total | Matched line by line |
| Onward referral | Not followed up | Referral logged with outcome requested |
Under-claiming means clinical time given for free. Incomplete records can also make the practice's service look less active than it is, which matters when services are reviewed.
How we build the service tracker
- Scheme appointment types are set up in your diary, so each booking is tagged with the service it belongs to.
- After each appointment, the tracker checks whether the scheme record has been completed. Where the scheme's system provides a way to read status, we use it; otherwise staff confirm with one click.
- Incomplete records prompt the optometrist the same day, while the appointment is fresh.
- Claims are tracked per appointment: ready, submitted, paid or queried.
- Payment statements are read and matched to appointments, and anything unpaid appears on a list by age.
- Onward referrals made during the service are logged, with a reminder to record any outcome your process requires.
- A monthly summary shows appointments, claims and payments by service.
We do not interpret the commissioner's service specification or decide what is claimable. The tracker applies the steps your practice follows for each scheme.
What the practice gains
Every scheme appointment is matched to a record and a claim. Missing records are caught the same day, not at month end. Payments are reconciled per appointment. And the practice can see how much of its time goes on each service and what it earns, which helps when deciding how much capacity to offer.
It also takes pressure off the optometrist. Urgent appointments are often squeezed between routine tests, and the last thing anyone wants at six o'clock is to remember which scheme records were left half finished. A same-day prompt, with a direct link to the right record, turns that into a two-minute task instead of a month-end hunt.
Is this happening in your practice?
- You provide one or more commissioned community eye services.
- Service records are completed in a separate system after the appointment.
- Claims and appointments do not match at month end.
- Payment statements are checked in total.
- Nobody owns the claims process for these services.