# 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 against each client's payers and levels of care, including InterQual, MCG, and plan policy, verify findings in the source record, and appeal faster.
- [SUD Utilization Review & ASAM Criteria | Circle Health](https://www.circlehealth.co/who-we-serve/substance-use-disorder): Keep ASAM assessments, payer-specific criteria, participation, authorizations, and billed services in agreement across outpatient, IOP, PHP, residential, and withdrawal management.
- [Mental Health UR: LOCUS, InterQual & MCG | Circle Health](https://www.circlehealth.co/who-we-serve/mental-health): Keep outpatient, IOP, PHP, residential, and inpatient psychiatric documentation ready for continued-care reviews against LOCUS, InterQual, MCG, and payer policy.
- [ABA Authorization & Unit Tracking | Circle Health](https://www.circlehealth.co/who-we-serve/applied-behavior-analysis): Keep ABA treatment plans, session notes, authorized hours and units, and billed units in agreement, and prepare reassessments from the treatment record.
- [Child Welfare Compliance: COA & CARF | Circle Health](https://www.circlehealth.co/who-we-serve/child-welfare): Keep child welfare contact notes aligned with state and county standards for safety, permanency, and well-being, ready for COA and CARF review, with supervisor visibility.
- [CCBHC Documentation & Compliance | Circle Health](https://www.circlehealth.co/who-we-serve/ccbhcs): Keep CCBHC and community behavioral health encounter documentation aligned with SAMHSA criteria and PPS requirements, ready for payer and state review.
- [Hospice Eligibility & Recertification | Circle Health](https://www.circlehealth.co/who-we-serve/hospice-care): Organize certification narratives, recertification evidence, level-of-care documentation, and election records for clinician review before billing.
- [Home Health Authorization: InterQual & MCG | Circle Health](https://www.circlehealth.co/who-we-serve/home-health): Reconcile approved care with completed visits, prepare commercial precertification against InterQual, MCG, or plan policy, and keep Medicare certifications ready.
- [Medicaid Program Integrity & Audits | Circle Health](https://www.circlehealth.co/who-we-serve/government-services): Help state health authorities, counties, public hospitals, and court programs check documentation against Medicaid and program rules before claims go out, and answer audits.
- [Book a Demo | Circle Health, the Payer Relationship System](https://www.circlehealth.co/demo): Book a personalized demo of Circle Health's digital assistants.
- [Trust & Security | Circle Health](https://www.circlehealth.co/trust): Security and compliance posture: HIPAA, encryption, EMR sync model.
- [Careers at Circle Health | Join the Team](https://www.circlehealth.co/careers): Open roles at Circle Health (engineering, clinical, sales, customer success).
- [About Circle Health | The Payer Relationship System](https://www.circlehealth.co/about-us): About Circle Health: mission, leadership (Keshav Vasudevan, Moe Chowdhury), values, team, and advisors.
- [Customer Stories | Circle Health](https://www.circlehealth.co/customers): Circle Health customer stories: Monument Recovery and Moving Mountains Recovery case studies, plus customer quotes.
- [ROI Calculator | Circle Health](https://www.circlehealth.co/roi-calculator): Interactive ROI calculator estimating annual opportunity across authorization, UR, compliance, and clinical capacity.
- [Demo Information: Plain Text Reference | Circle Health](https://www.circlehealth.co/demo-content): Plain-text demo information and value props.
- [Monument Recovery Case Study | Circle Health](https://www.circlehealth.co/case-study/monument-recovery): Monument Recovery case study: defensible authorizations and reduced charting time.
- [Moving Mountains Recovery Case Study | Circle Health](https://www.circlehealth.co/case-study/moving-mountains-recovery): Moving Mountains Recovery case study: 500+ page payer records request answered in under 30 minutes.
- [Blog | Circle Health](https://www.circlehealth.co/blog): Articles on UR, medical necessity, compliance, and clinical documentation.

## Blog

- [Circle Health Blog](https://www.circlehealth.co/blog): Payer requirements, utilization management, compliance, and documentation for healthcare operators.
- [Connecting Assessments, Treatment Plans, and Progress Notes Through the Golden Thread](https://www.circlehealth.co/blog/golden-thread-behavioral-health-documentation): Learn how to review the golden thread across assessments, treatment plans, and progress notes, including clinical details and structured EMR links.
- [What GLP-1 Research Means for Addiction Care](https://www.circlehealth.co/blog/glp-1-research-addiction-care): Explore the evidence on GLP-1s for alcohol use disorder, the role of habit change, and what emerging research means for addiction treatment providers.
- [Treating Stimulant Use Disorder Starts With Trust](https://www.circlehealth.co/blog/stimulant-use-disorder-treatment): Learn how trust, accurate documentation, contingency management, and consistent follow-up support treatment for cocaine and methamphetamine use disorders.
- [Technology Has to Deliver More Than a Better Note](https://www.circlehealth.co/blog/behavioral-health-technology-beyond-documentation): Evaluate behavioral health technology beyond documentation. Connect information to action, clarify ownership, and measure the full implementation cost.
- [Behavioral Health Quality Metrics: Turn Findings Into Action](https://www.circlehealth.co/blog/behavioral-health-quality-metrics): Learn how to connect behavioral health quality metrics, chart reviews, and clinical documentation to clear actions that support care and reduce repeat work.
- [How Payer Relationships Shape Behavioral Health Revenue](https://www.circlehealth.co/blog/how-payer-relationships-shape-behavioral-health-revenue): Learn how behavioral health payer relationships shape revenue, from clinical documentation and authorizations to reimbursement and denial management.
- [Behavioral Health Progress Note Examples and Writing Tips](https://www.circlehealth.co/blog/behavioral-health-progress-notes): Write clearer behavioral health progress notes with practical examples covering interventions, client responses, treatment goals, and next steps.

## Plain-text content

- [Full plain-text reference](https://www.circlehealth.co/llms-full.txt): All page content concatenated for ingestion.

## Contact

- Email: hello@circlehealth.co
- Demo: https://www.circlehealth.co/demo