Stay in good standing with every payer.
Remove the friction between quality care and reimbursement. Personalized to each payer's rules, Circle puts admissions, clinical, and revenue on a shared understanding before claims go out.
The payer relationship system for healthcare operators. Works with your EMR.
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
- Paid vs. contracted rateReview needed
- Out-of-network allowed amountReview needed
- Authorized vs. billed unitsComplete
“Having oversight 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×
- Treatment plan timeliness as census grows, Moving Mountains Recovery
- 93%
- Less time per chart, verified for medical necessity, Monument Recovery
- 65%+
- Insurance plan rulebooks processed across payers
- 1,000+
- Records processed across Circle customers
- 2M+
EMR
Holds the record
The legal clinical record: charts, notes, assessments, and treatment plans.
RCM
Submits the claim
Moves the claim to the payer and the payment back to the books.
Billing flow
- Claim submission
- Clearinghouse
- Payment posting
- Collections
Circle works alongside your EMR and RCM.
Measured results from customers.
Each result starts with understanding what the payer expects. Then the team takes the next step to meet it.
Chloe PetruzzoChief Strategy OfficerRandolph, NJ
Result
93%
Treatment plan timeliness as census grows
Read the story- Payer expects
- Treatment plans kept current as census grows
- Next step
- Gaps flagged in real time and turned into staff training
“We can identify gaps in real time and turn them into opportunities to train staff, so the same issues don’t keep coming up.”
Bradley WagnerClinical DirectorMesa, AZ
Result
65%+
Less time per chart, with every ASAM and LOCUS dimension checked for medical necessity before signature
Read the story- Payer expects
- Medical necessity shown across every ASAM and LOCUS dimension
- Next step
- Each chart checked against those criteria before signature
“You can’t argue with Circle’s validated record. It either meets medical necessity or it doesn’t.”
Stephanie NewmanLACVirtual provider
Result
50%+
Documentation time returned to Third Space clinicians
- Payer expects
- Complete notes for every session, finished on time
- Next step
- Notes drafted from dictation and reviewed by the clinician before signing
“The dictation tool has saved me an incredible amount of time and energy. I can get through my notes so much faster.”
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
4 settingsLevels of care, medical necessity, and accreditation on every chart.
Community and Post-Acute Care
3 settingsVisits, hours, and eligibility documented the way each program expects.
Enterprise and Revenue Operations
3 settingsPayer rules held consistent across sites, clients, and public programs.
No matter how you get paid, your payer needs proof.
Commonly asked questions.
Something else on your mind? Email hello@circlehealth.co.
See what each payer expects. And where every chart stands today.
In 30 minutes, we'll show you where your charts stand.
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