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VA Code in Flight Submission - Claims Process and Eligibility Enhancements (CP&EE) Business Requirements Document (BRD)
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Submitted by OI&T EPMO Lean Systems Engineering Open Source Coordination Office on 10-22-2015.
This BRD contains a variety of requested enhancements all related to the Claims Processing and Eligibility System (CP&E) system. The associated Change Requests (CR) have been submitted by CBOPC users in the local OI&T Change Management application (Serena Business Manager) over the course of months and years, reviewed, and prioritized as part of the ongoing operations and maintenance of the CP&E system.

The requested capability is generally to implement functionality as described in the collection of CRs identified as high priority by the OPS Directorate. This functionality generally involves:

• Initial claims processing
• Vendor selection and travel claims’ point of pickup
• Suspense queues claim review and clearing
• Modifications to document identification software and Optical Character Recognition (OCR) capabilities
• Automatic system imaging and storing of template letters requesting additional information
• Modification to replacement identification (ID) cards in regards to timely filing overrides
• Automation of retired reservist sponsors who become Tricare eligible
• Adding the ability to reprocess Electronic Data Interchange (EDI) claims

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