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Code in Flight Submission - Purchased Care - Program Integrity Enhancements v2, Iteration 1, Build 2.
Please use this identifier to cite or link to this publication: http://hdl.handle.net/10909/11076
Submitted by OI&T EPMO Lean Systems Engineering Open Source Coordination Office on 02-02-2017.
The Program Integrity Tools (PIT) system is a comprehensive set of tools to detect Fraud, Waste, and Abuse (FWA) for the CBPOC programs at the VA. The PIT is a solution based on International Business Machines Corporation’s (IBM’s) Fraud and Abuse Management System (FAMS) that will assist the VA in achieving its mission. This solution will serve as a single national source to view to Purchased Care Claims data, specifically providing systems integration to implement robust FWA toolsets to improve payment accuracy, centralized control of business rules, and FWA detection, as well as improved efficiency of processing, payment, or denial of health care claims submitted by non-VA providers. The system was built, tested, and deployed to the VA production environment in 2012, and has been addressing the claim scoring, centralization of claim data, and related reporting capability needs of the CBOPC programs.

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This revision makes available the in flight source code for v2, Iteration 1, Build 2.

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