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TARGETING
BETTER
HEALTHCARE
OUTCOMES

For more than a decade, Nexus has optimized the clinical review process for insurers, third-party administrators, brokers, consultants, attorneys, employers, and government entities.

Nexus - TARGETING BETTER HEALTHCARE OUTCOMES

Providing Expert Reviews In Various Spaces

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Workers’ Compensation

Efficiently manage workers’ well-being and claims

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Auto & General Liability

Delivering accurate reviews for evidence-based decisions

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Disability

Prompt return-to-work strategies

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Pharmacy

Evidence-based drug utilization management

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Government

Supporting the efforts of state and federal government agencies for over 10 years

Promoting Efficient and Appropriate Care

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Utilization Management

Proactively optimize care plans to ensure treatments are medically necessary and cost-effective, helping reduce unnecessary expenses and improve patient outcomes.

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Peer Reviews

Leverage independent assessments from board-certified specialists to validate clinical decisions, maintain compliance, and uphold quality standards.

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Specialty Bill Review

Closely examine complex claims that require specialized knowledge and expertise to uncover significant savings.

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Legal Review

Benefit from expert insights to navigate complex regulations, mitigate risks, and strengthen case strategies.

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Pharmacy Review

Ensure medication appropriateness, control drug costs, and enhance patient safety through comprehensive, evidence-based pharmacy evaluations.

WHY CHOOSE NEXUS?

Clinical
Excellence

Our board-certified physicians meticulously assess each case, minimizing the need for appeals and ensuring quality outcomes.

Privacy and
Security

Behind every clinical review, Nexus prioritizes the privacy and security of patient data. We monitor the evolving cybersecurity landscape to ensure current protocols are in place.

Innovative
Technology

We use proprietary, scalable platforms that adapt seamlessly to risk management and claims processing models, combining technology with a human touch to achieve optimal results.

Efficiency and
Integration

Nexus streamlines processes, ensuring swift and accurate information flow. Claimants receive timely care, leading to better outcomes and reduced overall medical costs.

Quality
Compliance

Amid complex regulations, Nexus rigorously adheres to accreditation standards and state and federal requirements to ensure the highest quality reviews.

Evidence-Based
Decisions

Nexus employs expert physicians to deliver accurate, evidence-based decisions - integrating quality at every stage to enhance workers’ comp and claims management outcomes.

Clinical Excellence

Our board-certified physicians meticulously assess each case, minimizing the need for appeals and ensuring quality outcomes.

Privacy and Security

Behind every clinical review, Nexus prioritizes the privacy and security of patient data. We monitor the evolving cybersecurity landscape to ensure current protocols are in place.

Innovative Technology

We use proprietary, scalable platforms that adapt seamlessly to risk management and claims processing models, combining technology with a human touch to achieve optimal results.

Efficiency and Integration

Nexus streamlines processes, ensuring swift and accurate information flow. Claimants receive timely care, leading to better outcomes and reduced overall medical costs.

Quality Compliance

Amid complex regulations, Nexus rigorously adheres to accreditation standards and state and federal requirements to ensure the highest quality reviews.

Evidence-Based Decisions

Nexus employs expert physicians to deliver accurate, evidence-based decisions - integrating quality at every stage to enhance workers’ comp and claims management outcomes.

Nexus - Physicians

Unmatched Quality,
Unparalleled Service

Nexus is a leading national independent clinical review and utilization management organization. With over a decade of experience, we specialize in providing innovative solutions that balance quality with superior outcomes.

We offer comprehensive services to insurance companies, third-party administrators, self-insured programs, government organizations, health systems, and government entities. Our portfolio includes workers’ compensation, group health, auto/general liability, disability, and pharmacy, and medical facilities.

BEYOND
REVIEWS

BEYOND REVIEWS

Nexus - Beyond Reviews
  • Nexus upholds stringent regulatory standards. Our commitment to compliance ensures confidence in our services.
  • URAC Accredited
  • Largest and most robust physician networks in the industry. Our panel of physician experts, selected based on high accreditation standards, covers over 98 specialties and subspecialties.
  • URAC Framework Updates: Nexus stays informed and aligned with the latest compliance requirements.
  • HIPAA Compliant: Patient privacy and data security are paramount.
Nexus - Beyond Reviews

Ready To Transform Your Clinical Review?

Our problem-solving solutions deliver quality results. Let us streamline your journey toward better patient care.