Government and Public Sector Healthcare
Program integrityand audit readinessfor public healthcare.
State health authorities, county agencies, public hospitals, and court programs work under constant public scrutiny. Circle checks casework and clinical documentation against each program's rules before claims are submitted or reports are filed, so public funds stay protected and teams stay ready for review.
Under 30 min
To answer a 500+ page records request
Every public dollar claimed or reported must be supported by records. Circle helps teams document according to each program's rules, while staff remain in full control.
Reimbursement structure
Funded across many public streams at once: Medicaid state plans and waivers, Medicare, Title IV-E, SAMHSA block grants, opioid settlement funds, and county appropriations, each with its own documentation rules.
Common criteria evaluated
- State Medicaid program rules
- 2 CFR 200 Single Audit
- CMS Conditions of Participation
- Medicare and Medicaid audit contractors
- State licensing and DMH/DPH codes
- Grant and settlement reporting terms
How it works in your daily routine.
Program integrity
Find payment risks before claims go out
Check encounter notes, signatures, and authorizations are against state program rules before claims go to the state or a managed care plan.
Public clinic encounter
- Complete
Provider enrollment
Active with state program
- Complete
Medical necessity
Rationale documented
- Complete
Service time and units
Duration supports billed units
- Review needed
Supervisor co-signature
Required for this provider
Built into every review.
Improper payment prevention
Circle checks medical necessity, enrollment, and required signatures before billing services to public payers.
Every program's rules, kept separate
State codes, waiver terms, grant requirements, and county contracts are stored in the rulebook and applied where needed.
Court and corrections programs
Recovery court phases, community corrections case notes, and clinical assessments are supported with role-based access for different teams.
Grant and settlement accountability
Service documentation is organized so programs can show how they used SAMHSA and opioid settlement funds.
Ready for any reviewer
Complete, cited records are assembled quickly for audit contractors, state inspections, and Single Audits.
Staff stay in control
Circle works with the systems you already use. Nothing goes into the system of record without staff review and approval.
What customers have measured.
Under 30 min
To answer a 500+ page records request
100%
Chart review coverage
49% to 90%
Compliance at Catholic Guardian Services
2M+
Records processed
Explore further
Who we serve
Health Systems and Provider Networks
Consistent oversight across sites, programs, and payers.
Who we serve
Child Welfare and Family Services
Contact notes that reflect safety, permanency, and well-being.
Who we serve
CCBHCs and Community Health
Encounter documentation that supports each billable visit.
Solution
Pre-Bill and Record Reviews
Documentation gaps caught before billing, and records ready for payer reviews.
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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