Targeting Better Healthcare Outcomes

For a decade, NEXUS has optimized the clinical review process for insurers, third-party administrators, brokers, consultants, attorneys, and employers.

Workers’ Compensation

Ensuring workers receive proper care to return to work rapidly.

Group Health

Ensuring members receive quality, medically necessary care.

Auto/General Liability

Accurate reviews of liability claims for evidence-based decisions.

Disability

Our goal is returning the claimant to work as quickly as possible.

Legal

We address every aspect of a medical claim for an accurate review.

The Leader in Independent Clinical Review and Utilization Management

NEXUS is the industry’s leading national independent clinical review and utilization management organization. Our focus is building long term, value-added relationships with our clients by providing access to quality, outcome-focused clinical expertise and innovative solutions.

For mitigating unrelated medical exposure, improving claims processing efficiency, and ensuring claimants receive excellent care on the way back to health, more companies are turning to NEXUS for help. We offer one of the largest, most robust physician networks in the industry, backed by a proven technology platform delivering faster, accurate, defensible results.

Helping you focus on Resolutions instead of process.

Our problem-solving solutions get quality results you can rely on.

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Efficiency

Every aspect of our platform has been designed for efficiency. When information flows through a system quickly and accurately, claimants receive quality, timely care with better outcomes, reducing overall medical spend.

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Innovation

Our proprietary, scalable platform adapts to any risk management and claims processing model and workflow. Our suite of solutions integrates seamlessly, aligning to unique process, technology, and reporting requirements.

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Quality

Challenging regulatory environments demand a stellar compliance approach. We keep our platform in sync with all URAC framework updates, and HIPAA compliance is the utmost priority for our team, reviewers, and clients.

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Results

Accurate, evidence-based decisions result from an established, highly trained panel of physician experts. We capture quality at each step, connecting it to each outcome for workers’ comp and claims management programs.

Innovating Clinical Review and Utilization Management

We can show you how our expertise, network, and platform can help.