Managing patient insurance coverages is essential for ensuring accurate billing, claim processing, and eligibility verification. This guide provides detailed instructions for adding, updating, and managing insurance coverages, attaching insurance card images, configuring insurer settings, handling subscribers and guarantors.
User's Guide
Adding New Coverage
Open the Patient Profile and locate the Coverages section on the right-hand side.
Click + Add Primary Coverage.
Attaching Insurance Card Images
There are two options for uploading insurance card images: either upload an image from the user's device or use the Canvas Remote iOS app.
Upload Insurance Card Images
In the Coverage modal, click Choose image (JPEG, PNG) for both the Front and Back of the card.
Select the image files from the user's device (computer, tablet, etc).
The uploaded images will display as thumbnails.
Images can be printed directly from the modal.
Using the Canvas Remote App (iOS Method)
Select Use Canvas Remote App in the Coverage modal.
Scan the displayed QR code using an iOS device.
Capture the front and back of the card and crop or resize the images as needed.
A blue checkmark will indicate a successful upload.
Refresh the Patient Profile to view the image thumbnails.
Removing Insurance Card Images
Click the trash icon
Confirm deletion
Re-upload a new image if needed
If the organization prefers to always use Canvas Remote for processing insurance card images, COVERAGE_DEFAULT_QR_SCAN_MODAL can be set to true in the Constance Config. This will ensure that the QR code automatically appears whenever new coverage is selected.
Entering Coverage Details
Payer Name: Select from active insurers
ID / Policy Number: Enter exactly as listed avoiding dashes, spaces or special characters
Group / Plan ID
Plan Name: PPO, HMO, etc.
Start / End Date: Define coverage period. Leave the end date blank if coverage does not have a defined expiration date
Coverage Type: Based on insurer configurations.
Copay / Coinsurance: Enter values from the card.
Claim Submission Address & Phone Number:
If set to Not Provided/Not Sure, Canvas auto-creates a task for follow-up.
Manually added entries are saved for future use when adding the same coverage to additional patient profiles
Missing address or phone data may cause lab order or prescription errors.
Adding a Subscriber
Subscribers carry the insurance plan for the patient. Subscribers can either be the patient or another individual.
Patient is the subscriber
When subscriber is the direct patient, select The patient is the subscriber
Someone else is the subscriber
When the subscriber is NOT the patient, select Someone else is the subscriber
If the subscriber is an existing patient, search for the subscriber in the dropdown.
If the subscriber is not part of the practice, enter their name and select Add [Name] and select the patient's relationship to the subscriber.
Complete the Add New Subscriber modal, filling in required fields such as name, date of birth, phone number, and address.
If the subscriber is not a patient of the organization, uncheck Is active patient to create them an inactive chart.
Adding Coverage Comments
Coverage-specific notes can be added for quick reference:
Use the Comments field in the coverage modal to enter free-text comments.
Comments can be updated at any time and are displayed on the coverage card in the profile view.
The first 200 characters of the comment will be displayed in the coverage card. Click the triple-dot menu on the card and View/Update to access the remaining information.
Modifying Coverage
Updating Coverage
Navigate to the Patient Profile and locate the desired coverage
Open the triple dot menu next to the coverage and select View/Update
Update any fields as necessary and select Update
If a patient's insurance information is changing, such as payers or ID numbers, DO NOT update the existing coverage directly by replacing it with the new insurance details. Instead, expire the current coverage and create a new entry for the updated insurance information. Simply modifying the existing entry will result in incorrect claim processing.
Expiring Coverage
To end a coverage period
Open the triple dot menu and select Expire
Enter an end date in the Expire Coverage modal and submit.
Expired coverages move to a new Expired Coverages section below active coverages.
Reactivating Expired Coverage
Expand the Expired Coverages section.
Open the triple dot menu next to the desired coverage and select View/Update.
Clear the end date by clicking the calendar icon and selecting Clear.
Select Done to reactivate the coverage, which will move back to the active coverages view.
Removing Coverage
Coverage can only be removed if it hasn’t been linked to a claim.
Open the Remove Coverage modal via the triple dot menu.
Confirm removal by selecting Remove.
Removing a coverage will PERMANENTLY delete the coverage. Once it is removed, it cannot be restored.
Changing Insurance Coverage on Claims
Sometimes, a coverage entry is incorrect and has already been associated with a claim. In such cases, the coverage needs to be updated.
Navigate to the patient’s profile and locate the current insurance coverage in the Coverages section.
Remove or expire the old coverage:
Expire: Add an end date to indicate when the coverage ended.
Remove: Delete the old coverage entirely from the patient's record. A removed coverage cannot be restored
Add the new insurance coverage, ensuring the start date reflects the policy’s effective date.
Open the relevant claim.
Click Show available coverages under the current coverages on the claim to expose the new coverage
Click the triple dot of the new insurance and click Add coverage to claim
The coverage list will not reflect all 3 coverages
Click the triple dot menu on the coverage that should not be on the claim and click remove coverage.
Changing Current Insurance
If a coverage is labeled as Current (highlighted in yellow), it cannot be removed from a claim. An alert, You cannot remove the current coverage, will display when attempting to remove it. To proceed, another coverage must be marked as current before the initial coverage can be removed.
Click the triple dot of coverage that should now be current
Select Set as current
The selected coverage will be updated to current (highlighted yellow)
The previous selected coverage will no longer be current and can be removed from the claim
Other Coverages
Beneath the medical coverages on the patient profile, there is a section for Other Coverages. Here any non-medical insurances the patient may need can be added (prescription coverage, auto insurance, etc.).
Click +Add under the Other Coverages heading
Follow the same step used for adding, updating or removing medical coverages
Coverage Eligibility
Canvas integrates with ClaimMD to provide real-time eligibility verification, ensuring that patient insurance coverage is active before services are rendered.
When Eligibility is Checked?
Automatic Checks
Triggered when new coverage is added or updated.
Runs automatically 3 days before scheduled appointments.
Manual Checks
From the Patient Profile, locate the coverage card.
Click the triple-dot menu > Verify Eligibility to run a check at any time.
Reviewing Eligibility Results
After a check, Canvas displays one of the following status indicators on the coverage card:
✅ Eligible — Coverage is active.
❌ Ineligible — Coverage is invalid; follow up required.
⚠ Error — The system encountered an issue processing the request.
For detailed information:
Select Review Eligibility from the triple-dot menu.
A modal will display eligibility details, including copay and coinsurance amounts (which can be edited if necessary).
Review all relevant data to ensure billing accuracy.
Patient Eligibility Defaults
By default, eligibility checks are processed using the organization's information. However, some insurers require the use of a specific provider's details.
Admins can configure this behavior in Settings > Quality & Revenue: Insurers by enabling Use provider for eligibility.
If this setting is active, ensure Patient Eligibility Defaults (provider or location) are defined to prevent processing errors.
Common Eligibility Errors
Payer does not support electronic eligibility: Manual verification required outside of Canvas.
Provider not enrolled: Ensure Tax ID and NPI are registered with the payer.
Invalid policy number format: Remove dashes or suffixes like "-01" from policy numbers.
Configuration & Set Up
Managing Insurers
Canvas pulls an initial list of insurers from ClaimMD, but organizations can manually manage insurers to align with their specific needs.
Adding a New Insurer
Navigate to Settings > Quality & Revenue: Insurers.
Click Add Insurer + in the top-right corner.
Complete necessary fields with the insurers information
Note: Fields in bold are required for proper claim processing.Click Save.
Modifying or Inactivating an Insurer
In the Insurers section, search by insurer name or payer ID.
Select the insurer to open the details.
Update necessary fields or uncheck Active to inactivate.
Click Save.
Managing Payer Addresses
Default addresses are essential for claim submissions:
Go to Settings > Quality & Revenue: Payer Addresses.
Search for the payer and select it.
Edit address fields or click Add Payer Address for new entries.
Ensure the address state is set to Active.
Click Save.
Accurate insurer and address configuration reduces claim rejections and manual corrections.
Configuring Eligibility Processing
Some insurers require eligibility checks to be processed using a provider’s credentials instead of the default organization data.
Set Provider-Based Eligibility
Navigate to Settings > Quality & Revenue: Insurers.
Locate the insurer and enable Use provider for eligibility.
For bulk updates, select multiple insurers and use the action menu.
Click Save.
Define Patient Eligibility Defaults
When provider-based eligibility is enabled, ensure that Patient Eligibility Defaults (provider or location) are set to avoid errors:
If defaults are missing, eligibility checks will fail.
Best Practice: Regularly review insurer settings to ensure compliance with payer requirements.
Constance Configuration Settings
Canvas offers flexible system settings via Constance: Config to control workflows, including how insurance card images are uploaded.
Image Upload Settings
COVERAGE_DEFAULT_QR_SCAN_MODALFALSE (default): Users are directed to upload images from their desktop when adding insurance cards to the patient profile.
TRUE: Users see the QR code for the Canvas Remote App by default when adding insurance cards to the patient profile.
Admins can toggle this setting based on organizational preference for image capture methods.
FAQs
Q: Why isn’t updated insurance coverage applied to existing claims?
A: Canvas does not detect changes made within an existing coverage entry as a new coverage event. To properly update insurance on claims, always expire or remove the outdated coverage and add the new coverage separately. Then, reassign any associated claims to the new coverage.
Q: What happens if I forget to set a claim submission address or phone number when adding coverage?
A: Canvas will automatically create a task to remind staff to complete this information. However, delays in updating these fields can cause issues with lab orders, prescriptions, or claim submissions.
Related Resources
Keywords & Metadata
• Keywords: insurance coverage, eligibility verification, insurance card upload, Canvas Remote App, subscriber management, guarantor, claim reassignment, Constance settings, insurer management, payer address
• Categories: insurance management