When it comes to uncovering crucial details in a claim or investigation, medical canvassing can provide valuable insights that traditional record requests alone cannot offer. Whether you're managing a complex workers' compensation case or validating a personal injury claim, medical canvassing adds an essential layer of transparency.
In this article, we’ll break down the top reasons to request a medical canvass—and answer the essential questions: Who, What, When, Where, Why, and How.
What Is a Medical Canvass?
A medical canvass is a targeted search of medical facilities within a specific geographic area to determine whether an individual has received medical treatment that has not been disclosed. It is a proactive tool used to uncover hidden or omitted medical history by contacting hospitals, urgent care centers, pharmacies, physical therapy providers, and more.
Who Typically Requests a Medical Canvass?
Medical canvasses are most requested by:
- Insurance companies (workers’ comp, auto, liability, health)
- Third-party administrators (TPAs)
- Defense attorneys
- Employers
- Private investigators
These professionals use canvasses to validate or challenge the accuracy of injury claims, identify pre-existing conditions, or uncover undisclosed treatment.
What Are They Looking For?
The goal of a medical canvass is to:
- Identify undisclosed medical treatment
- Verify the scope and timing of medical care
- Discover pre-existing conditions
- Confirm or dispute the cause of an injury
- Support a claim or legal defense
It’s not about denying care—it’s about ensuring accuracy and completeness in the information being used to make critical decisions.
When Should You Request a Medical Canvass?
Timing matters. A canvass is most effective when requested:
- Early in a claim, to establish a baseline medical history
- After red flags emerge, such as inconsistent reports or conflicting medical records
- Before settlement or litigation, to ensure all relevant treatment is accounted for
- In surveillance-supported investigations where physical activity doesn’t match claimed injuries
Proactive use of canvassing can avoid costly surprises later in the claim lifecycle.
Where Do You Look During a Medical Canvass?
A standard canvass typically includes a radius (e.g., 25 miles) around:
- The claimant’s residence
- The claimant’s workplace
- The location of the reported incident
Within this radius, canvassers contact a range of facilities, including:
- Hospitals
- Urgent care centers
- Physical therapy clinics
- Orthopedic offices
- Pain management clinics
- Pharmacies
- Chiropractic providers
Why Should You Request a Medical Canvass?
Here are the top reasons:
- Uncover Hidden Treatment
Claimants may omit prior injuries or treatments. A canvass can reveal medical visits not disclosed in the claims process. - Validate or Dispute Claims
Medical history found through canvassing can help determine whether the current claim is valid or exaggerated. - Improve Case Outcomes
The information gathered can lead to reduced settlements, denied fraudulent claims, or better preparation for litigation. - Ensure Due Diligence
Canvassing shows a proactive approach to claims handling and risk management. - Support Subrogation and Cost Recovery
Identifying third-party liability becomes easier when a fuller picture of medical care is available.
How Do You Request a Medical Canvass?
Working with a trusted provider like Compex makes the process simple:
- Submit a request form
- Specify key details: claimant name, DOB, SSN (if available), address, and incident details
- Choose the number of locations you want to search within a 25-mile radius
- Select the facility types you want to canvass
- Receive a detailed report with verified contacts, search results, and facility responses
Most canvasses are completed within 5–7 business days.
Final Thoughts
A medical canvass is more than a fact-finding mission—it’s a powerful tool for protecting your organization from fraud, ensuring fair outcomes, and making well-informed decisions. Whether you're investigating a suspicious claim or just need a clearer picture of medical history, a canvass provides clarity where there may otherwise be doubt.
Ready to take the next step?
Connect with Compex to request your next medical canvass or learn more about how it fits into your broader claims strategy.
