Pre-Authorization
A proactive review conducted before treatment is rendered to ensure medical necessity and alignment with evidence-based guidelines.
Concurrent Review
Ongoing assessment of care during treatment, especially for inpatient stays or complex cases, to support timely, medically appropriate decisions.
Retrospective Review
A post-treatment evaluation to confirm that services provided were necessary and compliant with medical standards.
Partner with Nexus for Effective Utilization Management
Only Nexus combines tailored workers’ comp utilization management with the gold standard of HITRUST certification—delivering unmatched security, trust, and results. With a clinically driven approach, timely turnaround times, and experienced physician reviewers, we help clients manage costs, improve care quality, and streamline claims processes.
