Utilization Management
Every review,ready beforethe window closes.
Prior authorization packets, concurrent reviews, payer forms, and live review talking points built from the chart and checked for medical necessity before submission.
3x
Concurrent reviews cleared per UR day
As reported by Circle customers
Approval is decided on the call. Walk in with the evidence already assembled.
How it works, in the daily work.
Prior authorization packet
- Complete
Medical necessity summary
Built from intake and assessment
- Complete
Payer form fields
Prefilled from the record
- Missing
Withdrawal risk evidence
Vitals from day 1 not yet attached
- Not due yet
Submission
Ready after one item
Built into every review.
Dozens of payers, kept separate
Each payer's forms, criteria, and deadlines stay distinct, across more than 1,000 insurance plan rulebooks.
Deadlines in view
Upcoming reviews and expiring authorizations surface before they become a scramble.
Live review talking points
UR teams go into each call with the evidence in the order the reviewer asks for it.
Appeals included
Appeal letters prepared from the record, with a checklist of what each payer expects attached, ready for clinician review before the filing deadline.
What customers have measured.
3x
Concurrent reviews cleared per UR day
As reported by Circle customers
+112%
More care authorized per review
As reported by Circle customers
30 min
To prepare an appeal
As reported by Circle customers
Explore further
Solution
Payer Relationship System
What every payer expects, standing with each, and the prepared context to act.
Solution
Documentation
Notes, plans, and assessments guided by what reviewers expect.
Solution
Pre-Bill and Record Reviews
Documentation gaps caught before billing, and records ready for payer reviews.
Who we serve
Substance Use Disorder (SUD)
Placement, participation, approvals, and billing kept in agreement.
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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