The operating layer for every payer relationship.
Built for healthcare organizations where reimbursement scrutiny never stops. Align documentation with payer criteria, give clinicians time back, and keep every chart ready for reviews and audits.
“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 day
- 3x
- Payer reviews cleared per reviewer day
- Less time to a compliant signed note
- 70%
- Less time to a compliant signed note
A system forthe relationship betweencare and payment.
EMR
Manages the patient record.
Stays the clinical record.
RCM
Manages the transaction.
Claims, remittance, and collections keep running as they do today.
Manages the payer relationship.
Payer criteria, review windows, and audit rules in one place.
Circle works alongside the EMR and reads the systems already in place.
The EMR holds the record. Billing tools process the claim. The payer relationship runs through every step in between.
From intake to the claim, five operational moments decide whether care gets reimbursed. Contracts sit across all of them. Each has an owner, and each owner answers one question.
Credentialing and operations
Search by name, NPI, or license number
Choose the states and the checks to run. Circle searches each source in the background, so staff can keep working while results come in.
See Credential HygieneProvider check
- Complete
NPI registry
NPPES, active
- Complete
State license
State board, active and registered
- Complete
Enforcement actions
State board, none found
- Complete
OIG exclusion
LEIE, not excluded
Different payment models. The same need to prove the work.
Fee-for-service
Encounters and procedure codes
Documentation that supports each billed code and the payer's criteria before the claim goes out.
Per diem and case rates
Authorized days
Medical necessity for the current level of care, shown in every concurrent review before the window closes.
Hourly and unit-based care
Authorized hours and units
Services delivered matched to what was authorized and documented, session by session.
Value-based and risk contracts
Quality and outcomes
Clinical progress shown in the record, defensible when contracts tie payment to care quality.
Public programs and grants
Program requirements
Each encounter traced to state rulebooks and program requirements, ready when oversight asks.
