# Circle Health AI Assistants - Automated Review UR, QA & Clinical Documentation
Discover Circle Health's AI-powered assistants for behavioral health facilities. Automate utilization review, quality assurance, charting, authorization, and claims processing. Reduce documentation time by 75%, increase revenue, and maintain audit readiness. 500,000+ encounters.
Circle Health's AI assistants automate documentation, utilization review, quality assurance, and claims processing across the entire patient lifecycle.
### Charting Assistant
**Automated Chart Creation**
Reduce charting time by 20+ hours per week with pre-built medical necessity and CPT code checks. Our CDI capabilities create charts from ASAMs to discharge reports in minutes with built-in ICD-10-CM/PCS coding and prior-auth prompts.
#### Problem: Documentation Taking Too Long?
Clinicians spend hours on documentation instead of patient care. Manual charting from ASAM assessments through discharge reports creates bottlenecks, delays authorizations, and increases the risk of coding errors that lead to denials.
#### Key Capabilities:
- Generates comprehensive charts, from ASAMs to discharge reports in minutes
- Notes generated in any format: SOAP, DAP, BIRP, GIRP, PIRP, PAIP, PIE, SIRP, or clinic-specific
- Built-in ICD coding with automatic code suggestions
- Prior-authorization prompts integrated into the workflow
- Real-time medical necessity validation for improved approval rates
#### How It Works:
Circle's Charting Assistant captures clinical encounters via ambient listening, post-session dictation, typing, or uploaded files. Automatically generating compliant documentation as clinicians work. It validates medical necessity in real-time, suggests appropriate ICD-10 codes, and prompts for the required prior-authorization elements, all before submission.
#### Available Templates:
- Custom assessments
- Progress note automation
**Key Benefit:** Increase clinical utilization by 50% and meet payer requirements at point of care.
### Authorization Assistant
**Prior Authorization Support**
Create completed prior authorization requests for treatment to reduce approval time and administrative burden. Secure initial and concurrent treatment authorizations at higher levels of care through automated chart reviews and live-review support.
#### Problem: Authorization Denials Costing You Revenue?
Manual utilization review processes are time-consuming and inconsistent. Facilities struggle to secure authorizations for higher levels of care, leading to premature discharges, lost revenue, and compromised patient outcomes.
#### Key Capabilities:
- Automates chart reviews for authorization submissions
- Live-review support during authorization calls
- Continued treatment, continued stay, clinical treatment, and face-to-face narrative documentation
- eFax authorization requests with complete documentation
#### How It Works:
Circle's Authorization Assistant monitors client charts and prepares authorization packets with all required documentation. You can easily track clinical and payer criteria, quickly assemble packets, and move forward with all supporting materials. Circle also provides real-time support during payer calls and manages payer faxing.
#### Available Templates:
- Payer-specific submission formats
**Key Benefit:** 3x UR daily case output. 2.5x approvals for higher levels of care.
### Review Assistant
**Recovery Progress Tracking**
Automated documentation review of patient progress, milestones, and treatment outcomes to demonstrate medical necessity and effectiveness. Ensure every chart meets TJC, NCQA, Milliman, CARF, BHCOE, and other standards with real-time compliance scoring.
#### Problem: Audit Anxiety Keeping You Up at Night?
Manual quality assurance can only review a fraction of charts, leaving facilities vulnerable to compliance failures. When audits arrive, teams scramble to fix documentation gaps, often working weekends to avoid accreditation issues.
#### Key Capabilities:
- Automated review of 100% of charts against standards
- Real-time compliance scoring across TJC, NCQA, Milliman, CARF, BHCOE, and others
- Identifies documentation gaps before they become problems
- Provides actionable feedback and resolution suggestions for clinical teams
#### How It Works:
Circle's Review Assistant continuously monitors documentation against regulatory, payer, and accreditation standards, providing instant compliance scores. It flags issues in real-time, allowing teams to address problems immediately rather than during audit or claim crunch time.
**Key Benefit:** Instant, automated compliance scoring keeps UR, QA, and clinical leaders audit-ready at all times.
### Claims Assistant
**Compliance & Reporting**
Ensure all documentation complies with your regulations, accreditation standards, and payer requirements for treatment. Confirm every claim meets payer documentation and coding requirements with automated pre-claim chart scrubbing and ICD↔CPT validation.
#### Problem: Leaving Money on the Table?
Claims denials and under-coding cost facilities millions annually. Manual pre-claim review can't catch all errors, and by the time denials arrive, the appeal window may have closed. Facilities lose revenue from missed billing codes and preventable denials.
#### Key Capabilities:
- Automated pre-claim chart scrubbing
- ICD↔CPT code validation and optimization
- Medical necessity linkage verification
- Identifies untapped billing opportunities
#### How It Works:
Before any claim is submitted, Circle's Claims Assistant performs comprehensive validation of all documentation, coding, and medical necessity linkages. It identifies missing codes, validates ICD↔CPT accuracy, and ensures every billable service is captured and adequately documented.
#### Available Templates:
- Pre-claim validation reports
**Key Benefit:** Accelerated claims while capturing untapped billing codes.
### Financial Health: Up to 15%
Increase in RVUs per patient
### Audit Protection: 100%
Pre-bill audit coverage
### Operational Efficiency: 75%
Reduction in documentation and administrative time
### Complete Coverage: End-to-End
Across patient lifecycle
**Circle Health Approach:**
Provide comprehensive coverage from pre-visit intake to post-visit review. Identify care opportunities that increase revenue, improve outcomes, and ensure compliance at every touchpoint. Our comprehensive approach extends authorized stays and decreases denials before they happen.
**Traditional Approach:**
Discover denials too late, leading to painful calls to insurance companies to justify medical necessity retroactively. Patients may face treatment interruptions, which could result in losing approval for ongoing care.
**Circle Health Approach:**
Identify opportunities for care at each stage, from initial documentation to final billing submission. Our multi-agent system guarantees that no patient slips through the cracks, boosting RVUs per patient while ensuring full compliance.
**Traditional Approach:**
Catching coding errors late can lead to missed care opportunities and revenue loss, which often become apparent only later. Conversely, over-coding increases the risk of audits, potential clawbacks, penalties, and compliance investigations, which could threaten accreditation.
**Circle Health Approach:**
Point-of-care medical necessity checks ensure that authorization requirements are met, providing detailed recommendations for resolving documentation issues. Multiple input methods are available, including voice dictation, session recordings, PDF uploads, and handwritten notes. Live chat with AI agents for support during authorization calls. Clinicians can dictate, with automatic formatting, and human-in-the-loop validation before adding them to records. Proactive approaches prevent surprises, minimize denials, and maintain continuity of care. Immediate feedback is given while documentation remains fresh.
**Traditional Approach:**
Payers often deny prior authorizations, causing weeks of delays and hindering patient care. Patients and practices must manually justify medical necessity, which can lead to clawbacks and disruptions in their treatment.
**Circle Health Approach:**
Seamlessly integrated into existing clinical workflows via EMR/EHR-agnostic API connections, ensuring compatibility and ease of use. Reduces the clinician documentation workload by up to 75%, dramatically decreasing charting time from 3-4 hours per patient to just minutes. Efficiency gains that directly tackle burnout and improve retention. Multiple input methods, including voice dictation, session recordings, PDF uploads, and handwritten notes, eliminate the need for manual data entry. Real-time conflict resolution provides actionable suggestions when issues occur, enabling immediate fixes. Enhances team capabilities without disrupting established processes.
**Traditional Approach:**
Backend-only processing forces teams to work overtime, leading to more time spent on documentation than on patient care. Teams often lack support during patient encounters and real-time conflict resolution, resulting in problems being identified too late. This burden increases turnover, creates care gaps, and exposes organizations to legal risks.
**Circle Health Approach:**
Deploy new autonomous agents and custom compliance rules in under 5 minutes. Rapidly adapt to changing payer requirements, state regulations, and organizational policies. Scale UR and QA capabilities without adding headcount. Maintain competitive advantage while traditional vendors require weeks or months for policy updates.
**Traditional Approach:**
Weeks or months to update policies and criteria—by then payer rules have changed again. Organizations fall behind on compliance requirements and get blindsided by new denial patterns. Teams remain stuck manually reviewing charts while denials pile up and revenue leaks. Compliance staff works weekends trying to catch up, leading to burnout while leadership questions operational efficiency.
**Focus:** AI-powered automation for utilization review, quality assurance, and clinical documentation