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VA Code in Flight Submission - RSD/SDD for Non VA Care Claims Processing Enhancements Program Integrity Tools (PIT)
Please use this identifier to cite or link to this publication: http://hdl.handle.net/10909/125
Submitted by OI&T EPMO Lean Systems Engineering Open Source Coordination Office on 03-13-2014.
The Program Integrity Tools (PIT) system was built, tested, and deployed to the VA production environment in Fall 2012, and has been addressing the claim scoring, centralization of claim data, and related reporting capability needs of Purchased Care Programs since. The Non-VA Care Claims Processing Enhancement work will expand the capabilities of the PIT system to allow for more comprehensive claim auditing procedures by integrating two additional VA source systems to track and measure claims and claims’ final payment adjudications. The Non-VA Care Claims Processing
Enhancement effort will be constrained to the following scope: The PIT shall transform claims- and payment-related data received from the following systems and load this data into the PIT Enterprise Data Repository:
a. Corporate Data Warehouse for Fee Basis claims payment status
b. CP&E Data Warehouse for CP&E claims and claims’ payment status

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