Coverages

Last updated: October 8, 2025

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

Accessing the Coverage Modal

  • Open the Patient Profile

  • 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.

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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)

  • In the coverage modal, select Use Canvas Remote App in the Coverage modal.

  • Scan the displayed QR code using the Canvas Remote App to link the app to the patient

  • 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

  • Open the coverage modal and click the trash can icon next to the image

  • Confirm deletion

  • Re-upload a new image if needed

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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

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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

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Someone else is the subscriber

  • When the subscriber is NOT the patient, select Someone else is the subscriber

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  • If the subscriber is an existing patient, search for the subscriber in the dropdown.

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  • 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.

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  • 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.

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Adding Coverage Comments

Coverage-specific notes can be added for quick reference:

  • Go to patient profile

  • Open the coverage modal

  • Go to the Comments section to add free-text comments pertaining to the coverage.

    • 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.

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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 coverage information is changing, such as payers or ID numbers, DO NOT overwrite existing coverage information. Instead, expire the current coverage and create a new entry. 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

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  • Enter an end date in the Expire Coverage modal and submit.

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  • Expired coverages move to a new Expired Coverages section below active coverages.

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Reactivating Expired Coverage

  • Go to the patient profile

  • Expand the Expired Coverages section under the active coverages

  • 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 or add a future expiration date if the date is known.

  • 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.

  • Click the triple dot on the coverage being removed

  • Select remove from the dropdown

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  • Confirm removal by selecting Remove

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    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

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  • Click the triple dot of the new insurance and click Add coverage to claim

  • The coverage list will not reflect all 3 coverages

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  • 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.

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  • 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 and select 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.

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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

  • Select Quality & Revenue: Insurers.

  • Click Add Insurer + in the top-right corner.

  • Complete necessary fields with the insurers information

    • Name: Name of coverage

    • Payer ID: Unique ID assigned to insurance company

    • Active: Checked if insurer should be listed in coverage dropdown

    • Clearinghouse: Claims should be processed through clearinghouse

      • Paper claims need to be submitted through the practice. Canvas does not send paper claims.

    • Type: General category of insurance

    • Transactor Type: Indicates submission format to the clearinghouse

    • Possible Coverage Types: Specific benefits the insurance may cover

    • Use for Submission: Alternate payer submissions will process through

    • Submit Claim with SSN: Check if claims need to be submitted with the SSN included

    • Use Provider for Eligibility: Check if coverage eligibility is ran through the provider and not the organization

    • Description: Any added details on the coverage

    • Accept Remittances From: Alternate payer ERAs will be accepted from

  • 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.

    Accurate insurer and address configuration reduces claim rejections and manual corrections.

Configuring Alternate Payers for Submissions and ERA Retrieval

Some insurers process their submissions through alternate payers or accept ERAs from other payers. To configure an insurer for this claim submission process:

  • Navigate to Settings

  • Select Quality & Revenue: Insurers

  • Choose the insurer that needs to submit and/or remit through an alternate payer

  • To select an alternate payer for claim submissions:

    • Locate the Use for Submission field

    • Select the payer from the dropdown menu (e.g., Medicare B for Medicare claims)

  • To enable remittances from other payers:

    • Locate the Accept remittances from field

    • Select the payer(s) the coverage can accept remittances from in the dropdown

  • Save your changes

Image Upload Settings

Organizations can opt to use Canvas Remote for processing insurance card images. Admins can toggle this setting based on organizational preference for image capture methods

  • Go to Settings

  • Click Constance: Config

  • Find the COVERAGE_DEFAULT_QR_SCAN_MODAL setting.

    • FALSE (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.

FAQs

Q: Why isn’t updated insurance applied to existing claims?
A: Always expire or remove old coverage before adding new. Only new entries can be assigned to claims.

Q: What happens if address or phone is missing?
A: Canvas creates a task to prompt follow-up, but delays may impact labs, prescriptions, or claims.

Q: How do I verify if a coverage is active on a claim?
A: Active coverages are shown in the claim header.

Q: Why doesn’t the activity log show secondary coverage changes?
A: The activity log may not display it. Check the claim directly under Show available coverages.

Q: What if secondary insurance was added after claim creation?
A: Add it manually to the existing claim. Future claims will include all active coverages.

Related Resources

Video: Patient Coverages

Video: Manage Insurers

ClaimMD Payer List

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