VBA Uses Automation to Tackle Claims Surge, Augment Workforce

The Veterans Benefits Administration’s Office of Benefits Automation launched its Automated Decision Support (ADS) process to streamline workflows and accelerate decision-making amid a growing volume of claims, Director Becky Lindstrom told GovCIO Media & Research. The office plans to expand its use of emerging technologies like AI to further enhance efficiency and augment its workforce.

VBA first piloted ADS in 2021 through a proof-of-concept at a single station. Since then, the technology has helped the agency manage rising claims, particularly those driven by legislation such as the PACT Act.

The process helps claims processors identify veterans’ medical or military service records. Summaries generated through the process enable claims processors to focus on the key details of a claims application without having to sift and search databases to find veteran records.

“We can summarize the information, and we can do some of those administrative tasks that claims processors would have to do and that would be retrieving medical records or retrieving service treatment records or requesting an examination,” Lindstrom said.

Inside the Office of Benefits Automation

Lindstrom said that legislation like the PACT Act, which made millions of veterans eligible for benefits, necessitated the need to automate certain aspects of the claims process and shrink the backlog.

Lindstrom’s office, which is nestled alongside the Office of Business Integration under the umbrella of the Office of Automated Benefits Delivery, centers around enabling automation and AI initiatives that reduce administrative burdens for VA employees. The three-year-old office today doesn’t do end-to-end automation, according to Lindstrom, but condenses and summarizes vast quantities of claims information for human processors to assess.

The office has a large language model it uses, but Lindstrom emphasized the model is part of a “rules-based process with some robotic process automation functionality.” She underscored that despite her office’s use of AI, claims processors are still an essential part of the process, and the AI tools developed are an aid, not a replacement.

“We’re creating tools because we still need those claims processors in the loop. We still need that claim decision to be done by claims processors,” Lindstrom said. “I need to bring them along with me or else I will fail miserably if I create these tools and they don’t work for the claims processors.”

Integrating Emerging Tech within VA’s Workforce

Lindstrom told GovCIO Media & Research that despite advancements in AI, the future work of the office will be keeping pace with the changing technology and continuously improving their tools for their employees.

“The continuous process improvement that we’ve made along the way is from these users that we really spoke candidly with and went back and said, ‘was this what you were intending to do or intending for us to do?’” Lindstrom said. “What we built three years ago looks extremely different than what we have right now and that’s that continuous feedback, that feedback loop and just improving things in in real time.”

Effective change management is a key component of tech’s success, but Lindstrom said it can be significantly challenging. Humility, especially from leadership and those that drive the change, is instrumental in instituting widespread change. Lindstrom explained stakeholder feedback is critical to improving digital experience, enabling transformation and tackling claims backlogs.

“I recognize that it starts early with humility. Even the best technology is still going to fall flat if it’s not shaped around the people who use it,” Lindstrom told GovCIO Media & Research.

“What is intuitive to you and and I might not be as intuitive to the folks that are actually completing the claims,” Lindstrom added. “We tried to build trust with them before and not after the fact. We wanted to bring them to the table as we’re developing these tools so that they’re in that process right from the beginning.”