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Months to minutes: VA speeds benefits services with automation
Technology Category
- Application Infrastructure & Middleware - Data Exchange & Integration
- Platform as a Service (PaaS) - Application Development Platforms
Applicable Industries
- Healthcare & Hospitals
- National Security & Defense
Applicable Functions
- Business Operation
- Human Resources
Use Cases
- Digital Twin
- Predictive Maintenance
- Process Control & Optimization
Services
- Software Design & Engineering Services
- System Integration
The Challenge
The U.S. Department of Veterans Affairs (VA) was facing a growing backlog of claims due to manual processing, specialized domain expertise requirements for claims processors, and competing priorities for key knowledge resources. Factors such as new legislation and the COVID-19 pandemic increased the urgency for a solution that could be delivered quickly. The VA needed a new, highly modern solution to shorten benefits claims processing and clear the claim backlog. The solution needed to integrate machine learning and business process automation to expedite pension, Dependency and Indemnity Compensation (DIC), and burial claims processing.
About The Customer
The U.S. Department of Veterans Affairs (VA) provides a variety of benefit services to nearly 22 million U.S. Veterans and their families. As part of VA, the Veterans Benefits Administration (VBA) provides a wide range of compensation and supplemental income benefits such as pensions and disability payments, life insurance, education funding (e.g., the GI Bill), loan services and more. The VA has been investing heavily in digital transformation to modernize and replace outdated technology, take advantage of industry best practices, and streamline business processes. However, the VA was facing a growing backlog of claims due to manual processing, specialized domain expertise requirements for claims processors, and competing priorities for key knowledge resources.
The Solution
The VA worked with Booz Allen Hamilton (Booz Allen) to define a solution that integrated machine learning and business process automation using Camunda Platform to expedite pension, DIC, and burial claims processing. The team used a model-driven design approach, opting to model business processes using standard Business Process Model and Notation (BPMN), and business rules using standard Decision Model and Notation (DMN) to establish a common understanding between the business subject matter experts and the IT Agile delivery teams. After a comprehensive market analysis and vendor evaluation, VA selected Camunda Platform as its process automation and microservices orchestration platform. Scrum teams first used Camunda’s open source edition to rapidly design and model five distinct processes covering claims intake, eligibility determination, claim development (collection of additional evidence), disability rating, and awards generation and authorization.
Operational Impact
Quantitative Benefit
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