Program Integrity Tools (PIT) Enhancements project outcomes will support Veterans Health Administration (VHA) Office of Community Care (VHA OCC) Systems Management, Community Care Performance Improvement and Reporting Directorate who must collaborate with the Financial Services Center (FSC) and Community Care Non-Network Care (CCNNC) to generate and coordinate timely and accurate reimbursement payments.
The project involves three related efforts.
1. Bi-Directional Feed with Electronic Claims and Management System (eCAMS) for Community Care Non-Network Claim processing
2. PIT Database Improvement
3. PIT Stabilization and Enhancements
These enhancements will allow scoring of claims, conducting pre-payment analytics, and real-time reporting critical to decision making and analytics while enhancing capabilities when performing Fraud, Waste and Abuse (FWA) activities. The enhancements will also facilitate reviews and claims payment dispositions, prevent improper payment, and streamline funds recovery. This will support VA compliance with agreed upon reimbursement timeframes, good stewardship of taxpayer dollars and integrity within government finances with contracted entities.