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Circle Health
Circle Health is the payer relationship system for healthcare. It connects the clinical, financial, payer, and operational systems a provider already runs, so every chart is aligned with what each payer expects while the client is still on census, authorizations are defended before the window closes, and the record is defensible before the claim goes out.
Their llms.txt
The beginning of the file, from our validated copy saved 2026-10-23T19:47:46.004Z. Cached copy · Source on circlehealth.co
# Circle Health
> Circle Health is the payer relationship system for healthcare. It connects the clinical, financial, payer, and operational systems a provider already runs, so every chart is aligned with what each payer expects while the client is still on census, authorizations are defended before the window closes, and the record is defensible before the claim goes out.
Circle works alongside the EMR through secure APIs; the EMR stays the clinical record, and clinicians review and sign before anything is written back. Proof: 3x concurrent reviews cleared per UR day, 100% chart review coverage versus roughly 10% sampled by hand, and 2M+ records processed.
## Pages
- [Circle Health | The Payer Relationship System for Healthcare](https://www.circlehealth.co): Overview of Circle: documentation, utilization management, compliance, credentialing, and billing connected into one view of every payer relationship.
- [Payer Relationship Management | Circle Health](https://www.circlehealth.co/solutions/payer-intelligence): Circle tracks what each payer requires, checks charts against it, and shows the next action before revenue is at risk. See the payer relationship system.
- [Defensible Clinical Documentation | Circle Health](https://www.circlehealth.co/solutions/clinical-documentation): Draft notes, assessments, and treatment plans checked against payer and regulatory criteria before signature. Notes drop from 25 to 30 minutes to 5 to 10.
- [Utilization Review: InterQual and MCG | Circle Health](https://www.circlehealth.co/solutions/utilization-management): Prepare concurrent reviews and prior auth packets from the chart, checked against InterQual, MCG, ASAM, LOCUS, or plan policy. Clear 3x more reviews per UR day.
- [Chart Audits: TJC, CARF & Payer Rules | Circle Health](https://www.circlehealth.co/solutions/qa-compliance): Review every active chart against payer, TJC, CARF, state, and organization criteria while the client is still in care: 100% coverage versus about 10% sampled by hand.
- [Provider Credentialing & License Checks | Circle Health](https://www.circlehealth.co/solutions/credential-hygiene): Check state licenses, the NPI registry, and OIG exclusions in the background, keep dated source results, and flag renewals before billing is affected. Early access.
- [Pre-Bill Chart Review & Payer Audits | Circle Health](https://www.circlehealth.co/solutions/pre-bill-reconciliation): Compare billed services with the chart before claims go out, and assemble cited evidence for payer records requests. Answer a 500+ page request in under 30 minutes.
- [Health System UR: InterQual & MCG | Circle Health](https://www.circlehealth.co/who-we-serve/health-systems): Help health system UM and quality teams check documentation against InterQual, MCG, and payer-specific criteria across sites, and prepare for every payer review.
- [Medical Necessity for RCM & Billing | Circle Health](https://www.circlehealth.co/who-we-serve/rcm-partners): Review documentation a
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