The operating layer for every payer relationship.
Know what each payer expects, where you stand, and what to do next. Across care, revenue, and credentials.
“Circle has been such a huge part of our clinical program. Without it, keeping everything running smoothly would be much more challenging.”
- Records processed
- 2M+
- Records processed
- Chart review coverage
- 100%
- Chart review coverage
- Payer reviews cleared per reviewer each day
- 3x
- Payer reviews cleared per reviewer each day
- Less time needed to complete a compliant signed note
- 70%
- Less time needed to complete a compliant signed note
A system designed formanaging the relationship betweencare and payment.
EMR
Handles the patient record.
Remains the clinical record.
RCM
Handles the transaction.
Claims, remittance, and collections continue to work as they do now.
Handles the payer relationship.
All payer criteria, authorizations, credentials, and billing rules are managed in one system.
Circle works with your EMR and connects to the systems you already use.
What Circle does. It starts with payer intelligence and helping your team through the necessary work.
Each payer has its own requirements for records, authorizations, claims, and care providers. Circle brings this information together, shows what each payer expects, and guides your team to the next step.
Where is your revenue at risk with each payer, and are you being paid fairly for the care you provide?
Leaders can see all payers in one place: where revenue is leaking, if reimbursement matches the care delivered both in and out of network, and what the records show before contract renewals.
Payer standing brief
- Review needed
In-network
Paid below the contracted fee schedule for this code
- Review needed
Out-of-network
Reimbursement below regional benchmarks for this service
- Review needed
Revenue risk
Auth gaps and unbilled units caught before billing
- Complete
Chart coverage
Every chart reviewed with cited clinical proof
Payment models differ, but you always need to show the work done.
Fee-for-service
Encounters and procedure codes
Documentation supports each billed code and meets the payer's criteria before you send the claim.
Per diem and case rates
Authorized days
Medical necessity for the current level of care is shown in every concurrent review before the review window closes.
Hourly and unit-based care
Authorized hours and units
Services delivered are matched to what was authorized and documented, session by session.
Value-based and risk contracts
Quality and outcomes
Clinical progress is shown in the record, making it defensible when contracts link payment to care quality.
Public programs and grants
Program requirements
Each encounter is linked to state rulebooks and program requirements, so you are ready when oversight asks.
