Healthcare payers must be able to detect and deter those few providers and beneficiaries who attempt to abuse or defraud their systems. While the individuals are few in number, the losses are substantial, and they affect both the bottom line and ultimately the quality of care. J-SURS from Thomson Reuters gives you a powerful and user-friendly stand-alone solution for fighting healthcare fraud and abuse. J-SURS not only integrates easily into your existing environment; it also provides easy, effective review and analysis of claims data to all users – from data specialists to medical professionals. 

Benefits

J-SURS is a suite of user-friendly, claims-based, data mining software applications designed to identify potentially fraudulent or abusive practices by both those who provide and receive healthcare services. It can be used to analyze fee-for-service and managed care encounter data from both private and government programs.

J-SURS allows you to generate real-time ad hoc reports that reveal outliers and unusual patterns of behavior. In addition, it helps you perform quick reviews or detailed assessments of suspicious situations.

In doing so, J-SURS gives your agency the ability to effectively monitor and evaluate its health programs, as well as the means to do the following:

  • Identify abusers of the healthcare system, both providers and beneficiaries
  • Introduce program reform measures and monitor results
  • Reduce healthcare costs over time
  • Recover funds and prosecute offenders

J-SURS Advanced Analytics

The industry-leading J-SURS healthcare fraud and abuse detection system combines outstanding data mining capabilities and high-volume output to address a wide range of healthcare fraud scenarios using Windows-based and On-Line Analytical Processing (OLAP) technologies.

With J-SURS, you can create customized databases of providers or beneficiaries with one set of easily defined criteria, rather than with multiple passes of the data.

J-SURS Report Generator

The J-SURS Report Generator helps you turn data into information, allowing you to look at your program from the vantage of claims and encounters, and giving you the means to respond to the many requests and demands that arise in the administration of your program.