Reliable Excellence in Clinical Review

Nexus specializes in providing independent clinical review and utilization management services for clients in workers’ compensation, group health, auto/liability, disability, and legal settings. We have an established reputation for delivering reliable excellence. Nexus has developed one of the largest physician panels in the industry, representing more than 1000 highly esteemed board-certified physicians in active practice across the nation.
Workers' Compensation
Nexus offers a comprehensive portfolio of clinical review solutions that ensure workers’ receive accelerated appropriate care and return to work rapidly; ultimately reducing the risk of excess, unnecessary medical exposure for Employers.
Group Health
Our group health utilization peer review services ensures that every member of a group health plan receives appropriate , quality care under the umbrella of covered services and medical necessity.
Auto/Liability
Nexus provides clinical review services for medical claims arising from automobile accidents and other claims against comprehensive and liability automobile insurance, including PIP/No-Fault claims.
Disability
For disability benefit claims, our goal is returning the claimant to work as quickly as possible. We provide impartial clinical review of short-term disability (STD) and long-term disability (LTD), and fraud and abuse (SIU) cases.
Legal
Nexus also supports legal teams working on medical cases where a clinical review is necessary to determine extent of related injury and a medical expert is required for deposition.

Additional Services

Medical Necessity Reviews
Workers Comp Reviews
Group Health (Internals/Externals)
Pre-Authorizations
Post-Service Retrospective Reviews
Appeals
Medication Reviews
Drug Utilization Reviews
CPT Code/Billing Reviews
Continuation of Care Plans
Vocational Consulting
Complex/Legacy/Peer Reviews
Standard of Care
Experimental/Investigational
Provider Review Services

Retrospective & Concurrent Length of Stay Reviews
Diagnostic Testing Reviews
Specialty Reviews including IRO
Long Term/Short Term Disability
Expert Testimony Services
Cost Projection Analysis
Medical-Legal Reviews
Functional Capacity Evaluations
Cost Containment Consulting Services
Drug Regimen Reviews
Chart Audit/ Hospital Peer Review
Bill Review
IME
Nurse Case Management
Physician Component Only