DVA claims hindered by processing system flaws

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DVA claims hindered by processing system flaws

Lacks visibility of staff workflow.

Australia’s national auditor has cast a spotlight on serious problems with claims processing at the Department of Veterans' Affairs amid a major program of work to improve support systems.

The Australian National Audit Office today delivered its assessment on how well the department delivers services to around 165,000 veterans.

It found “weaknesses in DVA’s business systems and processes” that have hampered its ability to process claims efficiently.

This is particularly the case with the department's new integrated support hub (ISH) system used to process rehabilitation & compensation (R&C) claims for veterans.

The ISH system was introduced to streamline claims processing after a $23.9 million investment in the 2016 federal budget.

It will eventually replace 18 legacy systems that a 2013 IT vulnerability review by the Department of Finance found wanting. The “systems supporting R&C processes had ‘a high risk of catastrophic failure’” Finance said at the time.

For the moment the ISH is still only being used for several - rather than all - claim types covered by the 18 legacy systems.

It is still not being used by DVA to manage workflow, “but rather as repository of records associated with a claim at the completion of processes”.

This is because the “ISH system does not require a sequential approach to processing of claims”.

The auditor said R&C claims were being primarily managed outside the processing system and “input ... when they are complete”.

“Testing identified that the workflow of R&C claims is primarily managed through the use of spreadsheets that are maintained outside of the primary processing system (ISH),” the audit states.

This approach to workflow management could mean that, in some instances, claims are lost between hand-off points.

The ISH system also lacks “controls to ensure integrity over the high volume of manual records placed in the system”.

Introducing the system for only several claim types has also meant that DVA staff are now “using multiple systems” to process claims, which “could affect timeliness and accuracy of processing”.

In response to the audit findings, the department said future ISH system releases would improve management reporting and monitoring.

At least some of the work is expected to overlap with future stages of the department's veteran centric reform program, which scored an additional $112 million in last month's budget.

The funding will be used to begin remediation work on 13 major systems that underpin income support business capabilities and support the R&C work that began following the 2016 budget.

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