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VETERANS’ HEALTH CARE - Preliminary Observations on VHA’s Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
/> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... , GAO obtained fiscal year 2015 data on the timeliness of VHA’s, Medicare’s, and TRICARE’s claims processing. GAO visited 4 of 95 VHA claims processing locations (selected on the basis of variation ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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General Accountability Office , issued in 2016
Risk cases: 6
The Ministry of the Environment lacks a compact information system and still uses 125 separate information systems and databases
The objective of the audit was to scrutinise the management of funds earmarked for the purchase and administration of ICT within the MoE and selected organisations which come under the management ... of the MoE. The audit identified the following risks: (1) non-existence of the Integrated environmental information system (IEIS) as an independent information system; (2) purchase of ICT, within the budget ... chapter of the MoE, through a state co-funded organisation CENIA which comes under the management of the MoE; (3) utilisation of the information systems. The audited period was 2010 to 2013; where relevant ... ... Ministry of the Environment manages 125 information systems and databases ... The Ministry of the Environment (MoE) has for more than 20 years a legal obligation to administer and manage an Integrated Environmental Information System (IEIS). In spite of this fact, the existing ... systems (more than 125 information systems and databases) are designed, implemented and managed as individual information systems without a direct integration into a joint point of reference.
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Supreme Audit Office of Czech Republic , issued in 2015
Risk cases: 7
Activities of the state in implementing the e-health system - Do the state, doctors and patients benefit from ehealth?
Estonia’s population is aging and the share of elderly people is increasing, as fewer children are being born and people are living longer. This creates a constantly growing need for health ... make the health system more efficient, improves people’s health via more effective prevention, raises the awareness of patients and also contributes to the more reasonable use of health resources ... and social services and patients are also becoming more and more demanding about the volume and quality of the services provided. The more extensive and systematic implementation of e-health solutions helps ... ... Why state, doctors and patients do not benefit from e-Health as much as they could? ... The report reviews whether the objectives set to the e-Health – ambitious multiyear program of Estonian Government - have been achieved. They are: higher quality of the health service and more ... efficient organisation of health care. As SAI Estonia found out, wide range problems started from two basic points: lack of strategic manager and unrealisitc schedule.
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National Audit Office of Estonia , issued in 2014
Risk cases: 3
Online fraud
Uneven response to online fraud This type of fraud can affect everyone, but yet it is not a strategic priority for local police forces and the response from industry is uneven. UK NAO underlines: For too long, as a low-value but high-volume crime, online fraud has been overlooked by government, law enforcement and industry. It is a crime that can affect everyone. Fraud is now the most commonly experienced crime in England and Wales, is growing rapidly and demands an urgent response. Yet fraud is not a strategic priority for local police forces, and the response from industry is uneven.
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National Audit Office , issued in 2017
Risk cases: 6
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