Phronesis Global Training Solutions LLC (PGT Solutions) today announced that it has been awarded a four-year, $38.7 million prime contract from the Veterans Benefits Administration (VBA) of the U.S. Department of Veterans Affairs (VA) to support the Modern Claims Processing (MCP) program.

Enhancing the VA’s Disability Claims Processing

As the prime contractor for MCP, PGT Solutions will assist the VBA with several tasks essential to its ongoing effort to modernize the disability compensation claims process:

• Business Process Improvement – Using data and human-centered design, the PGT team will identify opportunities for business process improvement that reduce the amount of manual data entry needed for claims processing, freeing up VBA staff time for higher-value decision-making activities.
• Improving Data Interoperability – The team will help the VA improve the interoperability of computable medical data, including automated hospitalization reporting and data integration of other clinical, laboratory, and 3rd party data associated with hospitalization adjustments, which impact benefit entitlement decisions.
• Medical Code Standardization – The team will assist the VA with mapping medical codes to standard criteria across Health Data Repository (HDR) records and other record repositories or systems. This will ultimately allow claims processors to use more accurate and efficient Automated Decision Support (ADS).
• Modernizing Claims Intake and Processing – The team will also assist the VA with modernizing and standardizing the processes and intake portal for Disability Benefits Questionnaires, as well as modernizing the Hospitalization Decision Ready Claims process by leveraging hospitalization report data to automate administrative activities leading up to claim decisions.

A Proven Team with Deep Expertise

PGT brings nearly a decade of specialized experience in its understanding of architectural and interoperability solutions within the VA healthcare system, focusing on internal health systems and data exchange between VA and external entities. PGT understands the VBA mission, stakeholders, and workflows, and brings a practitioner’s perspective to the diagnosis, redesign, and implementation of the agency’s business processes—building on VBA’s strengths to streamline and automate enhanced efficiencies.

Commitment to Supporting Veterans

PGT Solutions CEO Jena Jones, a service-disabled Veteran, recognizes the importance of creating modern, streamlined processes to support care for America’s Veterans. “Having outstanding doctors, frontline healthcare providers, and benefits claim adjudicators are essential to improving the VA claims and healthcare experience. But behind every claim are complex administrative and data-gathering tasks that can slow down the process. By automating these tasks with greater accuracy and efficiency, we’re proud to help free up critical resources, streamline decision-making, and ultimately improve outcomes for Veterans, their dependents, and caregivers.”