Substance Use Disorder (SUD)
Clinical need,approvals, and billingtelling one story.
As a client's needs change, the record has to keep up. Across outpatient, IOP, PHP, residential, withdrawal management, and inpatient programs, Circle keeps the active assessment, care delivered, authorization, and billed services in agreement.
+112%
More care authorized per review
As reported by Circle customers
An admission assessment cannot carry a whole stay. Continued care needs current evidence, and Circle helps teams assemble it.
Reimbursement structure
Inpatient, withdrawal management, residential, PHP, and IOP are typically authorized in blocks through concurrent review. Outpatient counseling is billed by service. Medicare pays enrolled opioid treatment programs through weekly bundles, which follow different logic than office-based care.
Common criteria evaluated
- ASAM Criteria
- 42 CFR Part 2
- 42 CFR Part 8 (OTPs)
- CARF
- The Joint Commission
- State licensing
Proud Affiliate Member of the National Association of Addiction Treatment Providers. Supporting addiction treatment teams across residential, PHP, and IOP programs. (opens in a new tab)
How it works, in the daily work.
Concurrent review preparation
- Complete
Current reassessment
Updated since admission
- Complete
Treatment response
Pulled from this week's notes
- Review needed
Medication change
Prescriber rationale not found
- Review needed
Discharge barriers
Housing placement pending
Built into every review.
Current evidence for continued care
Reviews built from recent assessments and treatment response, so the case for today's level of care is clear.
Participation reconciled
Approved services, actual participation, clinical notes, and billed services compared before claims go out.
Program-specific logic
Outpatient, IOP, PHP, residential, withdrawal management, inpatient, and OTP care each follow their own clinical and payment rules. Circle keeps them separate.
Documentation guidance
Clinicians see where a note needs more support while it is still open, and sign before anything enters the EMR.
Privacy handled precisely
Built with 42 CFR Part 2 in mind, including consent for treatment, payment, and operations and the added protection for SUD counseling notes.
Accreditation readiness
Every active chart reviewed against payer, CARF, TJC, and state criteria.
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
70%
Less time to a compliant note, expanding clinical capacity
As reported by Circle customers
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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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