Workers' Compensation Services

Robust Utilization Management

Balancing quality care and costs for Worker’s Compensation programs is complex and challenging. The solution is a Utilization Management partner with a robust service platform that enhances your medical management strategy. NEXUS delivers accelerated outcomes while effectively containing costs.

NEXUS provides a wide-range of workers’ compensation services that complement and support any type of worker’s compensation program across the nation. Our solutions and tools reduce unnecessary medical exposure, optimize the claims handling process, expedite delivery of quality care, and accelerate return-to-work outcomes.

The Clinical Experts
Our clinical review services support our clients at every stage of the injured workers’ continuum of care to accelerate a rapid recovery and return to work. The key to these services is our clinical expertise.

NEXUS offers a team of expert physicians and clinical support staff who guide our clients through the medical management process for workers’ compensation claims. Our panelists, supported by our independent clinical review platform, have clinical expertise needed to provide reviews with evidence-based recommendations quickly and cost-effectively. Defensible, timely decisions help employers and workers’ compensation plans with cost-containment.

Our Workers' Compensation Services Include:

Prospective Reviews
Retrospective Reviews
Concurrent Reviews
Physician Component Only (PCO)
Pharmacy/Drug Utilization Reviews

Peer Review/Physician Advisor
Drug Regimen Reviews
CPT/HCPCS/NDC, NDC Reviews
ICD-9/ICD-10 Code/Billing Reviews
Diagnostic Testing Reviews (Re-Reads)

YOUR MODEL, OUR PLATFORM

NEXUS has designed clinically sound cost-containment solutions for seamless integration into any workers’ compensation program model. We can tailor our platform to effectively align process, technology, and reporting for any unique workflow architecture.

Every aspect of our platform has been honed for efficiency, sustained by our state-of-the-art utilization review portal. Our physician portal was designed to optimize the reviewer’s expertise and reduce the administrative burden for all panelists and clients. Our customize client portal allows easy access real-time case information and determinations, rendering evidence-based decisions quickly and streamlined so your team can efficiently handle claims.

When utilization management information flows quickly and accurately, employers can focus on the core decision-making process in claims management.

ENHANCE YOUR UTILIZATION MANAGEMENT

Client-driven utilization review solutions help you get better results, faster.