Pre-Bill and Record Reviews
The evidencebehind every claim,within reach.
Catch missing signatures, unsupported services, and time gaps before claims are released. When a payer requests records or questions payment, assemble cited evidence from the chart in minutes.
Under 30 min
To answer a 500+ page payer records request
As reported by Circle customers
Approval does not guarantee payment. The record has to support every service billed.
How it works, in the daily work.
Pre-bill review
- Complete
Service documentation
Note supports the billed service
- Complete
Service time and units
Documented time meets the billed threshold
- Review needed
Provider signatures
Supervisory co-signature needed on one record
- Complete
Overlapping services
No conflicting service times found
Built into every review.
Chart to claim match
Each billed service compared with the documentation behind it before release.
Time and unit checks
Documented service time compared with the billed increment or threshold.
Signatures and orders
Missing provider signatures, supervisory co-signs, and orders flagged before the cycle closes.
Code to documentation fit
Billed codes checked against what the note shows, such as session length for 90837 versus 90834, before the claim goes out.
Underpayments in view
Paid amounts compared with contracted rates, so short payments surface while there is still time to dispute them, with regional rate benchmarks in view across frequent service codes.
Current and retrospective
Record reviews for active care and for audits after discharge.
Send what was asked for
Records requests answered with the documents tied to the request and the payer's criteria, with sensitive sections flagged for staff before anything leaves.
Appeals with cited evidence
Responses to denials and recoupment demands built from the chart.
Works alongside existing systems
Reads the EHR and billing systems already in place. No clearinghouse changes.
What customers have measured.
500+ pages
Payer records requests answered in under 30 minutes
As reported by Circle customers
30 min
To prepare an appeal
As reported by Circle customers
1,000+
Insurance plan rulebooks ingested
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What every payer expects, standing with each, and the prepared context to act.
Solution
Utilization Management
Authorizations and concurrent reviews, ready before the window closes.
Solution
Credential Hygiene
License, NPI, and exclusion checks with the source kept on file.
Who we serve
RCM Companies and Billing Partners
Documentation reviewed against each client's requirements, with less total reviewer effort.
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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