RCM Companies and Billing Partners
Protect every claimbefore the billing cutoff.With less total reviewer effort.
Gather each provider client's payer requirements and supporting records in one place. Spot any missing documentation, show providers what to do next, and get evidence ready for payer requests and appeals, with the source record available for your team to verify.
About 30 min
To prepare an appeal letter, down from hours
As reported by Circle customers
Billing teams inherit the records they receive. Give your team clear, verified information to fix documentation gaps before billing deadlines and to answer payer questions about claims.
Reimbursement structure
Different providers. Different payer requirements. Each provider client brings its own programs, levels of care, and documentation timing rules.
Common criteria evaluated
- Payer billing policies
- InterQual, MCG, and payer-specific criteria
- Level-of-care timing rules
- Client-specific rules
How it works in your daily routine.
Before billing
Timing and content, checked by level of care
Check document timing, signatures, and service time against each program and payer before the billing cutoff.
Pre-bill review
- Complete
Withdrawal management · Assessment
Completed within required window
- Review needed
Residential · Treatment plan
Signature missing
- Missing
IOP · Progress note
No note for date of service
- Complete
PHP · Group session
Documented time supports billed units
Built into every review.
Rules by level of care
Set up documentation timing, required assessments, and signatures based on each program, level of care, and payer.
Connected and uploaded records
Review records from connected systems or from chart packages sent by facilities that do not have an integration.
Verification without the search
Each finding appears next to its supporting document, so reviewers can confirm it without searching.
Provider fix lists
Give each provider client a clear list showing which records need attention and the reasons why.
Each client kept separate
Each provider client's payers, levels of care, and timing rules are kept in a separate Rulebook. This keeps one client's rules from affecting another's review.
Fits existing billing work
Share findings in formats that fit into the queues and spreadsheets your team already uses.
Appeals and records requests
Gather relevant notes and assessments into reviewed drafts when payers deny claims or request records.
What customers have measured.
About 30 min
To prepare an appeal letter, down from hours
As reported by Circle customers
100%
Chart review coverage
2M+
Records processed
Explore further
Solution
Pre-Bill and Record Reviews
Documentation gaps caught before billing, and records ready for payer reviews.
Solution
Utilization Management
Authorizations and concurrent reviews, ready before the window closes.
Who we serve
Health Systems and Provider Networks
Consistent oversight across sites, programs, and payers.
Know what each payer expects. Act before revenue is at risk.
See how Circle fits alongside the systems already in place.
Book Demo