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Cost of VA’s Electronic Claims System Worries Congress

claimsbacklog

By Debbie Gregory.

The good news is that the VA’s claims backlog, a major source of embarrassment for a number of years, has fallen impressively. The bad news is the price tag that goes along with the accomplishment.

The cost of VA’s paperless electronic claims network, called the Veterans Benefits Management System (VBMS), has already cost $1 billion. The cost will soon reach $1.3 billion, more than double the VA’s original estimate of $580 million.

The VBMS gets a software upgrade every three months, which, of course, is not free. And apart from quarterly upgrades, the VA is planning major innovations to the system, starting in 2018.

The size of the backlog peaked in March, 2013 at 611,000. Today the backlog is somewhere between 75,000 and 80,000, said Beth McCoy, VA’s deputy undersecretary for field operations. A VA claim is said to be in backlog status if awaiting a decision beyond 125 days of being filed. McCoy credited the decline in large part to the increasing effectiveness of the VBMS.

Rep. Jeff Miller, R-FL, complained that the backlog wasn’t eliminated by 2015, as promised by VA. Miller questioned how much credit VBMS deserves for the backlog’s sharp decline, noting that the Veterans Benefits Administration had hired 7,300 more full-time employees from 2007 to 2014.

In VA’s defense, McCoy said, “Scope and cost increases were planned, essential and approved to move beyond just an initial electronic repository functionality.”

She added that to better serve veterans as well as veteran service organizations and VA claim processors, VA steadily is increasing “automation functionality,” something they will probably never finish.

Miller has tried to make the case that paperless claims resulted in decisions of lesser quality, which accounted for a ballooning of claims on appeal.

McCoy disputed that, arguing that overall, claim accuracy scores had climbed from 83 percent in 2011 to 91 percent last year.

“Veterans are much better off because of the electronic system,” McCoy said. “We were outdated [and] should have done this years ago.”

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Military Connection: VA Makes Huge Dent in Claims Backlog

VA backlog

By Debbie Gregory.

A federal initiative to have the Department of Veterans Affairs (VA) provide timely decisions on disability payments to Veterans has passed another milestone on its way to eliminating the backlog of benefits claims.

The initiative has called for a major effort in applying new technology to transform the benefits claims process at the VA, and the transformation is achieving its goal. The inventory of backlogged claims has been reduced from a high of 611,000 claims in March, 2013, to less than 200,000 at the beginning of April. 2015. At the same time, the quality of the decision making has improved.

The VA’s Under-Secretary for Benefits, Allison Hickey, credits several factors for the massive dent made in eliminating the backlog. Hickey acknowledges the long hours put in by VA claims processors across the nation, most of whom have worked nights and weekends in their effort to eliminate the backlog by 67%.

“Make no mistake, we’re not slowing down short of the finish line,” Hickey said. “Our goal is to eliminate the claims backlog by the end of 2015 – meaning all Veterans will receive timely and accurate decisions on their disability claims.”

The under-secretary said that improvements in the Veterans Benefits Administration’s training and quality assurance programs helped VA employees to expedite through the existing claims.  They have also been able to keep up with new claims and maintaining acceptable levels of accuracy for their decisions. Hickey also credited the procedural efficiencies brought on by moving to an online paperless system.

Not long ago, claims processors trudged through an estimated five thousand tons of paper each year. In just the last few years, the VA converted claims processing to a digital format, where Veterans, as well as their dependents and beneficiaries, can submit claims for VA benefits and services online, accurately and efficiently.

Under the old system, Veterans had the potential to mail or fax in an incomplete or incorrect form. These incorrect or incomplete forms would then have to be mailed or faxed back to the Veteran to be corrected, and then mailed or faxed back to the VA once again. This was all very time consuming. But the online system will not allow Veterans to submit their claims forms without all of the necessary information, making it more efficient. It even allows applicants to upload their supporting documentation along with their electronic forms.

With the same amount of effort moving forward, the VA will hopefully get the backlog down to zero.

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Military Connection: VA Makes Huge Dent in Claims Backlog: By Debbie Gregory