Circle Health's AI assistants automate documentation, utilization review, quality assurance, and claims processing across the entire patient lifecycle.
Circle Health is a behavioral health AI platform built for addiction treatment and behavioral health facilities. Our four digital assistants automate clinical documentation, utilization review, compliance, and claims preparation — covering the full intake-to-discharge lifecycle.
Charting Assistant — Automated Chart Creation
Reduce charting time by 20+ hours per week with pre-built medical necessity and CPT code checks. Our CDI capabilities create charts from ASAMs to discharge reports in minutes with built-in ICD-10-CM/PCS coding and prior-auth prompts.
What it does:
- Generates comprehensive charts, from ASAMs to discharge reports in minutes
- Notes generated in any format: SOAP, DAP, BIRP, GIRP, PIRP, PAIP, PIE, SIRP, or clinic-specific
- Built-in ICD coding with automatic code suggestions
- Prior-authorization prompts integrated into the workflow
- Real-time medical necessity validation for improved approval rates
How it works:
Circle's Charting Assistant captures clinical encounters via ambient listening, post-session dictation, typing, or uploaded files. Automatically generating compliant documentation as clinicians work. It validates medical necessity in real-time, suggests appropriate ICD-10 codes, and prompts for the required prior-authorization elements, all before submission.
Outcome: Increase clinical utilization by 50% and meet payer requirements at point of care.
Authorization Assistant — Prior Authorization Support
Create completed prior authorization requests for treatment to reduce approval time and administrative burden. Secure initial and concurrent treatment authorizations at higher levels of care through automated chart reviews and live-review support.
What it does:
- Automates chart reviews for authorization submissions
- Live-review support during authorization calls
- Continued treatment, continued stay, clinical treatment, and face-to-face narrative documentation
- eFax authorization requests with complete documentation
How it works:
Circle's Authorization Assistant monitors client charts and prepares authorization packets with all required documentation. You can easily track clinical and payer criteria, quickly assemble packets, and move forward with all supporting materials. Circle also provides real-time support during payer calls and manages payer faxing.
Outcome: 3x UR daily case output. 2.5x approvals for higher levels of care.
Review Assistant — Recovery Progress Tracking
Automated documentation review of patient progress, milestones, and treatment outcomes to demonstrate medical necessity and effectiveness. Ensure every chart meets TJC, NCQA, Milliman, CARF, BHCOE, and other standards with real-time compliance scoring.
What it does:
- Automated review of 100% of charts against standards
- Real-time compliance scoring across TJC, NCQA, Milliman, CARF, BHCOE, and others
- Identifies documentation gaps before they become problems
- Provides actionable feedback and resolution suggestions for clinical teams
How it works:
Circle's Review Assistant continuously monitors documentation against regulatory, payer, and accreditation standards, providing instant compliance scores. It flags issues in real-time, allowing teams to address problems immediately rather than during audit or claim crunch time.
Outcome: Instant, automated compliance scoring keeps UR, QA, and clinical leaders audit-ready at all times.
Claims Assistant — Compliance & Reporting
Ensure all documentation complies with your regulations, accreditation standards, and payer requirements for treatment. Confirm every claim meets payer documentation and coding requirements with automated pre-claim chart scrubbing and ICD↔CPT validation.
What it does:
- Automated pre-claim chart scrubbing
- ICD↔CPT code validation and optimization
- Medical necessity linkage verification
- Identifies untapped billing opportunities
How it works:
Before any claim is submitted, Circle's Claims Assistant performs comprehensive validation of all documentation, coding, and medical necessity linkages. It identifies missing codes, validates ICD↔CPT accuracy, and ensures every billable service is captured and adequately documented.
Outcome: Accelerated claims while capturing untapped billing codes.
200,000+ clinical encounters reviewed annually. 3x UR daily case output. 2.5x approvals for higher levels of care. Up to 50% increase in clinical utilization. 100% chart audit coverage versus ~10% with manual review. 4–8 week implementation. Customers include Pyramid Healthcare, Monument Recovery, CodeMax (250+ facilities), and Catholic Guardian Services (compliance from 49% to 90%).
Eleos focuses on documentation only. Charta focuses on claims only. Brellium focuses on compliance only. Circle Health covers the complete clinical lifecycle, built specifically for substance use disorder and behavioral health from day one.