eAdjudication: Business Rule Development, Testing, and Validation
Abstract
Electronic adjudication (eAdjudication) is an automated process by which investigations are electronically reviewed to assess for the presence of derogatory information. eAdjudication applies business rules to identify whether there is any information within the case that requires human review. Past efforts have demonstrated that eAdjudication results in a very high number of incorrect unfavorable determinations, sending a large number of cases to human review that are then granted favorable outcomes (e.g., Baweja et al., 2019). This report presents the results of eight rule modification tests to the business rules for Tier 1 and Tier 3 investigations that were intended to decrease the rate of false alarms without creating the risk of any incorrect favorable determinations (i.e., potential misses). Results showed that, by modifying permissible values (i.e., allowing additional results to pass derogatory information), researchers were able to decrease the false alarm rate by 9 for Tier 3 investigations and by 19 for Tier 1 investigations. Specific recommendations for the business rules and for increased efficiency in testing rule modifications are presented.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jun 01, 2020
- Accession Number
- AD1101641
Entities
People
- Charles G. Morse
- Jessica A. Baweja
- Leissa C. Nelson
- Ray A. Zimmerman