Targeting Better Healthcare Outcomes

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

Leaders 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.

NEXUS is the industry’s leading national independent clinical review and utilization management organization

Helping you focus on patients 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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Results

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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Quality

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.

Helping you focus on patients instead of process

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