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Streamlining the Medical Debt Relief Process for Veterans

For veterans saddled with medical copayment debt, the Veterans Health Administration (VHA) has long had a program in place to relieve their financial burden. But to get approved, veterans had to endure a time-consuming manual application process.

That is until Tria Federal helped VHA adopt an electronic platform for veterans to request medical debt relief. Just five months after President Joe Biden ordered VHA to simplify the medical debt waiver process, VHA began using the Veteran Online Debt Access (VODA) portal for this purpose. The new online application reduced the previous application’s required fields by 90 percent. 

This increased efficiency led to 8,700 veterans being approved for medical debt relief in the first year after VODA’s launch. VHA is the largest integrated health care system in the United States. 

“There are still cases where a manual review is needed, but in many cases the veteran debt waiver is approved automatically,” said Ricky Patel, a director with Tria. “The VODA portal not only simplified the debt relief process for veterans, but it also increased access. More than 90 percent of submissions on the VODA portal are from veterans who have never applied for debt relief.”  

Before VHA adopted the VODA portal, it was used by the Veterans Benefit Administration (VBA). Tria helped VHA adjust and leverage the online system to meet its unique needs.  

Under VHA’s old process, veterans had to print the 5655 Debt Relief form, fill out the lengthy application, and physically mail the hard copy to their designated Consolidated Patient Account Center (CPAC). Once the form arrived at the CPAC, it would wait in a queue until VHA staff worked through the paperwork. Veterans would either receive communication that the debt relief was approved, or if not approved, would have to work with the CPAC to provide additional information. Veterans can still choose to apply for debt relief in person or by sending in a hardy copy. 

The key to automating the approval process was the development of a machine learning algorithm that uses a decision tree to make predictions. The decision tree works by analyzing the numbers in a veteran’s application and uses logic written by VHA to electronically determine whether to approve the veteran for debt relief. To ensure accuracy, the established logic allows for the system to generate a tentative approval decision, which is than validated by VHA staff. 

Tria provided VHA with project management, risk management, milestone creation and tracking support, and worked with various agencies to define and implement the future state. Tria also organized a weekly call to communicate project deployment updates to upper-level stakeholders from the Office of General Counsel (OGC), Debt Management Center (DMC), VHA Deputy Chief of Staff, VHA Deputy CFO, Office of Management and Budget (OMB), Office of Information and Technology (OIT), Office of Finance (OF), and the majority of VHA Revenue Operations leadership.  

“The project’s success stemmed from the value that high-priority individuals at the VHA placed on it, ensuring efficient progression,” Patel said. 

Learn more about Tria’s support for the Department of Veterans Affairs.