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J-SURS™ - Fraud and Abuse Detection System

Healthcare payers must be able to detect and deter those few providers and beneficiaries who attempt to abuse or defraud their systems. While these individuals are few in number, the associated losses are substantial, and worst of all – they take money away from being able to serve the health needs of your population.

J-SURS from Truven Health Analytics gives you a powerful and user-friendly stand-alone solution for fighting healthcare fraud, waste, and abuse. Our solution 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 and investigators.

This solution provides a suite of user-friendly, claims-based, data mining components 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, inappropriate utilization, 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.

 

Benefits
  • The leading CMS-certified SURS solution in 15 states
  • Easily used by non-technical team members
  • Identify abusers of the healthcare system, both providers and beneficiaries
  • Create custom databases of providers or beneficiaries with one set of easily defined criteria
  • View data in a variety of formats (e.g., standard grids, multi-dimensional cubes, charts & graphs).
  • Ability to “drill” into the claims data of a provider or beneficiary quickly, easily and effectively

 

J-SURS Report GeneratorJ-SURS Report Generator image
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.

 

 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.