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Process excellence personal service simply the best.

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Presentation on theme: "Process excellence personal service simply the best."— Presentation transcript:

1 process excellence personal service simply the best

2 2 The Nexus History Nexus was founded in San Marcos, Texas in 2009 with three employees, a number which now stands at more than 60 with several positions available. The success of the Nexus System, coupled with an increasing demand for expedited and high quality medical reviews, brought very rapid growth to our company. With the rapid growth came a greater need for larger office space. In late 2010, Nexus Medical Consulting purchased and remodeled the former Thermon engineering building along the Interstate 35 business corridor. Our new home provided the ability to grow and fill 13,000 square feet of office space. After a few short years, we have outgrown this space and will soon begin a new construction phase for additional space. Today, the Nexus System is being introduced to a rapidly growing number of physicians, healthcare organizations, and legal professionals throughout the United States and abroad.

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4 4 Who Nexus Is? Nexus provides legislatively driven determinations of medical necessity and medical appropriateness for patients and claimants throughout the United States and more recently on a global scale. We provide our clients with the best independent, accurate, and evidence-based results available. Nexus Medical Consulting is a medical cost containment company dedicated to delivering quality service to our claims and risk management partners and the legal, governmental and business communities.

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6 6 What does Nexus Do? We provide unique communication and case coordination efforts between our clients and our medical network in a highly customizable format. Our trained in-house medical staff prepares or “cues” cases in a clear and concise format, acting as a comprehensive resource for compliance with the evidence-based guidelines. Our administrative staff “packages” the medical cases for our physician network. The Nexus System alleviates the time that the physicians would normally have to spend on burdensome paperwork. The Nexus System is unique in that we streamline the independent review process for our clients.

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8 8 90% 10% Nexus Business Volume

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10 10 Primary Services  Utilization Review –all States  Legal and Exam Services  Healthcare Finance and Analytics  Cost Containment Consulting

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12 Nexus Medical Consulting has set the standard of excellence for independent reviews. Nexus specializes in providing various types of medical reviews to many, nationally recognized and accredited Companies. Nexus has a reputation with our clients for delivering reliable excellence in the shortest amount of time. Our competency is proven to serve our clients' needs, and enables our physicians to be more productive. These organizations continually turn to Nexus and our physicians to provide various high quality reviews such as: Pre-Authorization Reviews Post-Service Retro Reviews Complex/Legacy Reviews Drug Utilization Reviews EMG/NCV Reviews Short/Long Term Disability Reviews Long Term Disability Reviews Group Health Reviews Nexus currently represents a panel with hundreds of highly esteemed physicians across the nation. Our physicians perform reviews in the fields of Neurosurgery, Orthopedic Surgery, Orthopedic Spine Surgery, General Surgery, Hand Surgery, Physical Medicine, Pain Medicine, Occupational Medicine, Emergency Medicine, Psychiatry, Psychology, and many more. Nexus employees are trained, coordinated, and committed to producing the very best in Medical and Legal Review. Our trained medical staff is educated to serve our physicians as a resource in managing the complexities of the evidence-based guidelines. Our skilled administrative staff is conversant in the needs of our clients and is able to provide optimal clerical assistance. Utilization Review

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14 What are Independent Reviews? A systemized process Reviews the following:  Medical Necessity  Appropriateness o …of health care being provided o …of health care being proposed to be provided o …of health care that has been provided 14

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16 Legal & Exam Services

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21 21 QUESTIONS?


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