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The Veterans Benefits Administration (VBA) is using process automation developed by ÎÞÓÇ´«Ã½^® to handle burial and dependency and indemnity compensation (DIC) claims faster and with more accuracy. With an automated process that uses algorithms and digital data extraction, claims that once took months are now decided in a matter of minutes. Just as importantly, this innovative solution has produced an efficient, cost-effective, and repeatable process that VBA can follow to adopt new software applications and spur further IT modernization efforts.ÌýÌý

Now, VBA is preparing to scale automation to other types of claims processing. The veterans service representatives who previously handled pension claims without the aid of automation will be free to dedicate more of their time to claims that require human intuition. As a result, VBA is serving the families of our nation’s veterans faster while preparing to address future challenges with agile, tech-forward solutions.

Consider the following scenario: A Vietnam veteran passes away from service-connected conditions and his widow files a claim with VBA requesting DIC and burial benefits. The claim, which consists of a death certificate and supporting documentation, becomes the responsibility of a veterans service representative whose job is to verify the benefits the widow is eligible to receive.

To make the correct determination, the representative must cross reference the information submitted in the claim with the data stored in VBA databases. Complicating the process is that claims documents often contain common errors, or present key information in inconsistent formats. And multiple veterans service representatives often work on a single claim, meaning the reasoning behind the final decision must be easily understandable to all.

The amount of analysis that processing a typical DIC or burial claim requires can create delays and backlogs, which then results in slower service to the families of deceased veterans. VBA has partnered with ÎÞÓÇ´«Ã½ to solve this problem through a scalable technological framework.ÌýÌý

Process automation, which uses advanced algorithms to classify large data sets and conduct problem-solving operations at a speed much faster than humans, is an ideal technology to handle an analysis-heavy task like processing DIC or burial claims. We helped train algorithms to compare death certificate data against previously rated disabilities, determine veterans’ proper service connection, and award the correct level of burial and DIC claims.

To enable the algorithms to replace manual claims processing, we created a way to store all claims data in a structured form, then devised a framework to assimilate the structured data into VBA’s Benefits Integration Platform (BIP)—the cloud-based solution that coordinates all applications and software packages throughout VBA’s IT infrastructure.

Our framework consists of the following custom-built components:Ìý

• Benefits Processing Data (BPD): Automated claims processing starts with our BPD service. Scanning vendors digitize and perform data extraction on the paperwork submitted as part of claims, transforming unstructured data found on death certificates and supporting documents into structured data that key classifiers can read and analyze in a fraction of the time it takes humans. This sets the stage for automation to drive the process.
  
  
• Orchestration Engine: We used open source technology to create a central orchestration engine to weave all these technologies together within the existing BIP environment and coordinate every step in the automation process. The engine also captures data on how different business and operational procedures unfold. This data capture gives VBA insight into where changes in business rules and processes might result in greater efficiencies and improved outcomes.

Pension automation is a demonstration of process automation at its best. Since launching in May 2020, the key classifiers have successfully awarded more than 4,000 claims. VBA can now expect a higher rate of accuracy in both grant and deny determinations, as well as a decrease in false positives. The agency can also feel confident in the accuracy of the decisions it issues. Because the key classifiers work seamlessly within the BIP environment, our teams have been able to make incremental improvements and updates without interrupting the claims process.

In addition to processing claims faster, our automation solution is:

• Capturing data in executable forms and providing VBA with macro-level insight into how veterans service representatives across the agency have been trained to process pension claims.
  
• Analyzing existing decision models and decision points that drive how claims are processed.

Using automation for burial and DIC processing has set the stage for VBA to implement a similar approach to other claims services it oversees on behalf of our nation’s veterans. By partnering with ÎÞÓÇ´«Ã½, VBA is taking advantage of the transformational power of automation and further evolving its IT capabilities.

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