Compliance and QA
Identify gaps.Give teams a clear pathto fix them.
Check every chart against payer criteria like InterQual, MCG, and plan-specific policies, plus accreditation, state, and organization standards. Instead of reviewing a small sample later, send each issue directly to the person who can address it today.
100%
Chart review coverage
Sampling finds problems after discharge. Continuous review finds them while there is still time to act.
How it works in your daily routine.
Focus your review
Spot the areas that need attention right away
With every active chart reviewed, QA teams can focus on records that need attention instead of searching for them.
Active charts
- Complete
Chart 12
All required documents present
- Late
Chart 7
Progress note unsigned for 48 hours
- Not due yet
Chart 19
Treatment plan update due Friday
- Missing
Chart 3
Consent form not found
Built into every review.
A tool compliance can stand behind
Staff use an approved tool within their workflow, not consumer apps that risk client information. Every finding links back to the record and the rule it relates to.
Gap detection
Missing, late, and incomplete documentation is surfaced while there is still time to correct it.
Action Items
Findings are sent to the person responsible for fixing them, with a clear status.
One Rulebook
Keep payer, accreditation, state, and organization standards all in one place.
Coaching, not policing
Teams understand what reviewers expect and the reasons behind it, helping documentation improve over time.
Ready for records requests
Charts remain organized and ready for payer, accreditation, and state reviews.
What customers have measured.
2M+
Records processed
100%
Chart review coverage
49% to 90%
Compliance at a child welfare agency
500+ pages
Payer records requests answered in under 30 minutes
As reported by Circle customers
Explore further
Solution
Payer Relationship System
What every payer expects, standing with each, and the prepared context to act.
Solution
Documentation
Notes, plans, and assessments guided by what reviewers expect.
Solution
Pre-Bill and Record Reviews
Documentation gaps caught before billing, and records ready for payer reviews.
Solution
Credential Hygiene
License, NPI, and exclusion checks with the source kept on file.
Start with one workflow the team already runs.
Choose the review or document the team needs help preparing. Confirm the records available, configure the requirements and output, and check the results with the people who will use them.
- 01
Choose the work.
Start with an appeal, a concurrent review, or a chart-review checklist.
- 02
Confirm the inputs.
Review the supported connection or upload process, the documents it provides, and the requirements the team uses.
- 03
Validate with the team.
Check the evidence, output format, and staff workflow before expanding use.
Does every workflow require an EMR integration?
Some review workflows can use uploaded records. Connected workflows depend on the EMR, available access, and configuration. Confirm the approach for the organization during implementation.
Who checks the output?
The team reviews the draft and supporting evidence before signing documentation or submitting materials to a payer.
How do we measure whether it is helping?
Agree on a baseline for the selected workflow, such as preparation time, rework, or review throughput, and compare it with the team's experience after rollout.
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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