VBA expands automated claims system

VBA expands automated claims system

The Veterans Benefits Administration (VBA) has expanded its pilot program focusing on automated processes using certain medical data. The program being run by the newly created Office of Automated Benefit Delivery was launched in December 2021 and is designed to eliminate unnecessary examinations, streamline workflows and reduce manual components of the claims process.

Initially, the pilot program focused on claims for increased benefits relating to service-connected hypertension. The automation capabilities have now been expanded to include claims for increases in asthma and sleep apnea.

The goal of the pilot program is to decrease the amount of time claims decisions currently take. Claim decisions take over 100 days to complete using the traditional disability claims process due to the amount of manual activities required. Initial results from the pilot program decreased that number to just two days. By utilizing data sets specific to a veteran’s military service, claims and medical histories, VBA will be able to deliver claims decisions with greater accuracy, efficiency and consistency, according to the administration.

In a statement to the House Committee on Veterans’ Affairs Subcommittee on Disability Assistance and Memorial Affairs, American Legion National Security Director Mario Marquez highlighted The American Legion’s support for a discussion draft of the Department of Veterans Affairs Principles of Benefits Automation Act. The legislation would direct the Secretary of Veterans Affairs to submit to Congress a plan to modernize VBA’s information technology systems.

“Research suggests that the inevitability of automation by government agencies will improve efficiency and effectiveness,” Marquez stated. “The American Legion believes VA must continue to adapt and be on the cutting edge of this technological innovation to address the rising claims backlog. However, the ‘human element’ must not be removed from the claims adjudication process.

“This discussion draft would safeguard against the improper use of automation that could infringe upon veterans’ right to due process or the VA’s duty to assist veterans and their dependents.”

The pilot program is just one avenue VA is taking to modernize the department’s technology. Replacing the more than 30-year-old software that tracks and stores patient information is one of its top priorities. VA began the process of overhauling and modernizing its health-record system in 2017 with the implementation of an electronic health record (EHR) system.

The new EHR system is a single, shared platform between VA, the Department of Defense (DoD) and the Department of Homeland Security’s U.S. Coast Guard (USCG). By using a single platform, information will be able to be shared between VA, DoD and USCG. The system went live at its third location at the VA Central Ohio Healthcare System in Columbus on April 30.

To learn more about VA’s transition to Electronic Health Records, visit ehrm.va.gov/resources/faqs.