Credential Hygiene
Provider eligibility,checked continuously,before claims go out.
If a license lapses or an exclusion goes unnoticed, reimbursement can be at risk even after care is provided. Circle checks state licensing boards, the NPI registry, and OIG exclusions in the background and saves a dated copy of each result.
Every check
Saved with a dated copy of the source page
Credentialing is usually done when someone is hired and at renewal. But payer eligibility matters every day in between.
How it works in your daily routine.
Run a check
Search by name, NPI, or license number
Pick the states and checks you want to run. Circle searches each source in the background, so your staff can keep working while the results come in.
Provider 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
Built into every review.
Multi-source checks
State licensing boards, the NPPES NPI registry, board enforcement actions, and the OIG exclusion list all run together.
Every state a provider practices in
Add the states you want to check and match each license number to the correct board and license type.
Source captured
A dated copy of each source result is saved with the provider record for payer and accreditation reviews.
Scheduled re-checks
Registry, license, and exclusion checks repeat on a schedule, so you don’t need to run manual searches.
Expirations surfaced early
Upcoming license expirations appear next to the next action, so you see them before billing is affected.
Connected to the payer picture
Provider standing appears with documentation, authorizations, and pre-bill review, making eligibility part of every payer relationship.
What customers have measured.
4 sources
NPI registry, state license, enforcement actions, and OIG exclusions in one check
1 click
To the source page captured when a check ran
100%
Chart review coverage alongside provider standing
Explore further
Solution
Payer Relationship System
What every payer expects, standing with each, and the prepared context to act.
Solution
Pre-Bill and Record Reviews
Documentation gaps caught before billing, and records ready for payer reviews.
Solution
Compliance and QA
Every active chart reviewed while the client is still in care.
Know what each payer expects. Act before revenue is at risk.
See how Circle fits alongside the systems already in place.
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