Clinical peer review plays a critical role in verifying the quality, appropriateness, and medical necessity of care in workers’ compensation claims. Conducted by board-certified, actively practicing physicians, these reviews provide objective evaluations of medical records to guide accurate claims decisions, reduce unnecessary treatment, and support recovery by aligning care with evidence-based guidelines.
Peer reviews determine whether treatment is both necessary and directly related to the workplace injury.
Treatment plans are evaluated for consistency with clinical best practices and industry standards.
Reviews provide insight into an injured worker’s functional capacity and readiness to safely resume job duties.
Partnering with Nexus for clinical peer review services ensures every case is evaluated by a trusted panel of specialists with expertise in workers’ compensation. Our reviews are timely, defensible, and focused on delivering clarity and accuracy to support better claims outcomes.
When it comes to workers’ compensation, clinical peer review is indispensable for ensuring that treatments are medically necessary, appropriately targeted, and backed by objective clinical insight. At Nexus, we lead the industry in delivering rigorous, evidence-based peer reviews by board-certified, practicing physicians—helping payers make more informed decisions, reduce unnecessary care, and support healthier outcomes for injured workers.