Stay in good standing with every payer.
Circle checks every chart, review, credential, and claim against what each payer expects, so every team works from the same rules.
The payer relationship system for healthcare operators. Works with your EMR.
“Having oversight of all charting across every client is a game-changer, especially as our census grows.”
Chloe PetruzzoChief Strategy Officer, Moving Mountains Recovery- Authorized days per review, national RCM partner
- 2×
- Authorized days per review, national RCM partner
- Treatment plan timeliness as census grows, Moving Mountains Recovery
- 93%
- Treatment plan timeliness as census grows, Moving Mountains Recovery
- Less time per chart, verified for medical necessity, Monument Recovery
- Over 65%
- Less time per chart, verified for medical necessity, Monument Recovery
- Insurance plan rulebooks processed across payers
- 1,000+
- Insurance plan rulebooks processed across payers
- Records processed across Circle customers
- 2M+
- Records processed across Circle customers
Your EMR holds the record.Your billing system sends the claim.Circle knows what each payer expects.
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.
Every payer's criteria, authorizations, credentials, and billing rules, in one system.
Circle works with your EMR and connects to the systems you already use.
Start by understanding what each payer expects, then take the steps to meet those requirements.
Each payer has its own rules for records, authorizations, claims, and clinicians. Circle brings these rules together, shows your chart status, and guides your team on next steps.
See where revenue is at risk with every payer, and whether you're paid fairly for the care you deliver.
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
Measured results from customers.
Care providers and RCM partners use Circle to increase successful reviews, maintain audit readiness as they grow, and let clinicians focus on patient care.
Randolph, NJ
93%
Treatment plan timeliness as census grows
“We can identify gaps in real time and turn them into opportunities to train staff, so the same issues don’t keep coming up.”
Read the storyChloe PetruzzoChief Strategy Officer
Mesa, AZ
Over 65%
Less time per chart, with every ASAM and LOCUS dimension checked for medical necessity before signature
“You can’t argue with Circle’s validated record. It either meets medical necessity or it doesn’t.”
Read the story
Bradley WagnerClinical Director
Virtual provider
Over 50%
Documentation time returned to Third Space clinicians
“The dictation tool has saved me an incredible amount of time and energy. I can get through my notes so much faster.”
Stephanie NewmanLAC
Circle is built for every team that answers to a payer.
Every care setting has different payer rules. Find yours and see what Circle checks for you.
Behavioral and Specialty Care
Levels of care, medical necessity, and accreditation on every chart.
Community and Post-Acute Care
Visits, hours, and eligibility documented the way each program expects.
Enterprise and Revenue Operations
Payer rules held consistent across sites, clients, and public programs.
No matter how you get paid, your payer needs proof.
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.
