CCN Provider Directory
Description
Reduce the need for manual review of a large (1.5M+ providers, 9M+ provider services) dataset of provider information to categorize or perform data governance functions.
Detailed example
- Determination of the Harassment Prevention Program (HPP) criteria - Finding and retrieving providers based on their locations and medical/@dental services provided - Data quality and compliance with federal standards, such as address, zip codes, and rurality
AI / analytics pattern
Classical/Predictive Machine Learning: Models trained on data to make predictions or classifications based on identified patterns or relationships.
Automation level / stage
a) Pre-deployment – The use case is in a development or acquisition status.
Expected benefit
Maintaining a highly accurate and properly categorized dataset of VA and Community Providers actively providing healthcare to our Veterans ensures accurate and timely Veteran referrals, appointment scheduling, and facilitation of healthcare program service authorization. Additionally, applying AI to the consolidated Provider dataset allows critical federal review of provider activity and enables discovery of fraud, waste, and abuse for the program.
Controls / human review
ATO: Not reported; PIA: Not published