Nexus PPT - Greater San Marcos Partnership

personal service
process excellence
simply the best
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.
Who Nexus Is?
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.
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.
What does Nexus Do?
The Nexus System is unique in that we streamline the independent review process for our
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.
Nexus Business Volume
Primary Services
 Utilization Review –all States
 Legal and Exam Services
 Healthcare Finance and Analytics
 Cost Containment Consulting
Utilization Review
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
Complex/Legacy Reviews
EMG/NCV Reviews
Long Term Disability Reviews
• Post-Service Retro Reviews
• Drug Utilization Reviews
• Short/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.
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
Legal & Exam Services

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