WellSpace Nexus is a non-profit organization created to optimize care for vulnerable people by partnering with healthcare providers, federally qualified health centers, health plans, and independent physician associations to better meet patients’ unique healthcare needs with an enhanced integrated network of care.
Achieving regional health through high quality comprehensive care.
WellSpace Nexus is an affiliate of WellSpace Health, a non-profit system of community health centers that have served local neighborhoods since 1953. WellSpace Health is accredited and certified by The Joint Commission, the nation's premier quality assurance organization.
WellSpace Nexus facilitates care, in partnership with healthcare providers, federally qualified health centers, health plans, and independent physician associations, that will drive long-term sustainable improvement in health. WellSpace Nexus focuses on direct-to-patient care innovation that reduces healthcare complexity by simplifying the system and driving higher quality outcomes.
WellSpace Nexus makes utilization management decisions based on careful review of cases by medical professionals. All medical decisions are made using evidence-based guidelines. These guidelines are available upon request by calling 916.737.5577. Each case is reviewed for appropriateness of care, verification of coverage and the allowable levels of benefits in the plan. WellSpace Nexus does not specifically reward practitioners or other individuals for issuing denials of coverage. Furthermore, WellSpace Nexus does not offer financial incentives to utilization management decision makers to encourage decisions that would result in under-utilization of care.
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