Pre-Bill and Record Reviews
The evidencebehind every claim,within reach.
Find missing signatures, unsupported services, and time gaps before you send out claims. If a payer asks for records or questions a payment, quickly gather the evidence you need from the chart.
Under 30 min
To answer a 500+ page payer records request
As reported by Circle customers
Approval does not guarantee payment. The record has to support every service billed.
How it works in your daily routine.
Pre-bill review
Service documentation confirmed before release
Circle checks queued services against the clinical record. This way, documented time, needed signatures, and overlapping services are handled before claims are sent.
Pre-bill review
- Complete
Service documentation
Note supports the billed service
- Complete
Service time and units
Documented time meets the billed threshold
- Review needed
Provider signatures
Supervisory co-signature needed on one record
- Complete
Overlapping services
No conflicting service times found
Built into every review.
Chart to claim match
Each billed service is checked against its supporting documentation before it is sent.
Time and unit checks
The documented service time is checked against the billed increment or threshold.
Signatures and orders
Missing provider signatures, needed supervisory co-signs, and orders are flagged before the cycle ends.
Code to documentation fit
Billed codes are checked against the note shown, such as session length for 90837 versus 90834, before the claim goes out.
Underpayments in view
Compare paid amounts with contracted rates so short payments surface while there is still time to dispute them, with regional rate benchmarks in view across frequent service codes.
Current and retrospective
Record reviews for active care and for audits after discharge.
Send what was asked for
Answer records requests with documents tied to the request and the payer's criteria, flagging sensitive sections for staff before anything leaves.
Appeals with cited evidence
Responses to denials and requests for repayment are built using information from the chart.
Works alongside existing systems
Circle works with your current EMR and billing systems. You do not need to change your clearinghouse.
What customers have measured.
500+ pages
Payer records requests answered in under 30 minutes
As reported by Circle customers
30 min
To prepare an appeal
As reported by Circle customers
1,000+
Insurance plan rulebooks ingested
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What every payer expects, standing with each, and the prepared context to act.
Solution
Utilization Management
Authorizations and concurrent reviews, ready before the window closes.
Solution
Credential Hygiene
License, NPI, and exclusion checks with the source kept on file.
Who we serve
RCM Companies and Billing Partners
Documentation reviewed against each client's requirements, with less total reviewer effort.
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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