Hospice Care
Eligibility, approvals,and care levels,in agreement.
Hospice teams answer to traditional Medicare, Medicare Advantage, Medicaid, and commercial plans at once. Circle helps teams track initial and continued authorization windows, verify care-level changes against approvals, and keep election and certification timelines ready for review.
100%
Chart review coverage
Admission approval does not cover every day or change in care level. Circle keeps approvals, eligibility evidence, and claims aligned across every payer.
Reimbursement structure
Traditional Medicare pays per diem across four levels of care within 90-day and 60-day benefit periods. Medicare Advantage and commercial plans often set their own authorization windows, care-level approvals, and covered-item terms. Medicaid adds state-specific authorization and dual-eligible rules.
Common criteria evaluated
- Medicare Hospice CoPs
- Hospice LCDs
- State Medicaid hospice rules
- Medicare Advantage and commercial review guidelines
- HOPE reporting
- State licensing
How it works, in the daily work.
Authorization tracking
- Complete
Initial authorization
Approval period active
- Review needed
Continued-care review
Due in 5 days, updated notes needed
- Review needed
Level of care change
Routine home care to inpatient respite
- Missing
Respite approval
Not found for this level of care
Built into every review.
Authorization and review tracking
Initial and continued review periods, approval dates, and level-of-care changes followed before claims go out.
Payer-specific criteria
Prognosis documentation and decline evidence organized against the criteria of the payer on file.
Level-of-care reconciliation
Routine home care, continuous care, respite, and general inpatient checked against approvals and contract terms.
Election and certification timelines
Benefit periods, face-to-face encounters, election documents, and physician signatures tracked so nothing is late.
One plan across the team
Notes from every discipline compared against the plan of care, with HOPE tracked from submitted to accepted.
Clinicians decide eligibility
Circle organizes the evidence. Eligibility decisions and physician attestations stay with clinicians, and it works alongside the EMR.
What customers have measured.
100%
Chart review coverage
70%
Less time to a compliant note, expanding clinical capacity
As reported by Circle customers
2M+
Records processed
Know what each payer expects. Act before revenue is at risk.
See how Circle fits alongside the systems already in place.
Book Demo