Is Medical Canvassing Still Useful Today?

Technology has transformed claims investigations: faster access to medical records, more connected data systems, and deeper digital insights into claimant behavior. With AI-driven retrieval and nationwide health information networks, some in the industry are beginning to ask a reasonable question: Do we still need medical canvassing?

The short answer: yes, because it fits strategically into modern claims investigations.

How Technology Shapes Today’s Claims Investigations

There’s no denying that today’s investigators have tools that didn’t exist even five years ago. These advancements have reshaped how information is gathered and how quickly decisions can be made in claims investigations. However, despite the progress, each tool still has blind spots, especially when it comes to finding treatment a claimant hasn’t disclosed.

AI-Assisted Medical Record Retrieval

Automated retrieval platforms can streamline releases, track authorizations, and sync records directly into claim systems. They improve efficiency, but only when the provider is already known and participates in a connected network. If treatment occurs outside that ecosystem, the trail goes cold.

Pharmacy & Prescription Data

Prescription intelligence can reveal medication history and treatment timelines. It’s incredibly useful, but it can’t always identify the provider behind the script or confirm whether the medication aligns with reported injury or care.

EHR Connections & Health Information Networks

Electronic Health Records (EHRs) and Health Information Exchanges (HIEs) have expanded significantly. In 2023, 70% of hospitals could electronically send, receive, locate, and use patient data from other facilities, but fewer than half do this consistently, leaving major visibility gaps.

Social Media & Digital Footprint Analysis

Digital footprint insights provide behavioral context, including mobility, travel, and recreational activity, even routines that may suggest ongoing treatment. But they cannot confirm diagnosis, document restrictions, or identify treating physicians.

How Medical Canvassing Captures What Technology Misses

Even the most advanced digital investigation tools share a major limitation: they can only analyze data that exists online and is connected to the right networks.

That leaves significant blind spots in claims investigations, especially in healthcare. For example, many providers fall completely outside the digital footprint:

• Small private medical practices
• Pain management clinics
• Walk-in or urgent care facilities
• Cash-only providers
• Newly opened clinics or treatment centers
• Offices not tied into national health databases or major networks

If a provider doesn’t bill through large systems, submit to national databases, or have an established online presence, artificial intelligence and database searches simply can’t find them.  Medical canvassing fills that gap.

The Unique Value of Medical Canvassing

Medical canvassing is most effective when used strategically, deployed where technology leaves blind spots. Industry sources define medical canvassing as an investigative process that identifies undisclosed medical treatment or providers by contacting clinics, hospitals, pharmacies, and related facilities within a geographic radius.

Instead of pulling clinical records, canvassing confirms whether treatment occurred at all, especially when claimants receive care outside digital ecosystems like national databases or major EHR networks.

Here’s where canvassing delivers unique insights in modern claims investigations:

• Uncovering Undisclosed Treatment: Whether intentional or accidental, some claimants omit providers, which can change causation, liability, and compensability. Medical canvassing verifies what’s missing.
• Identifying Providers Outside Databases: Many clinics, such as small practices or new facilities, simply don’t connect to big databases. Medical canvassing can confirm treatment where technology cannot.
• Clarifying Conflicting Information: When pharmacy data, adjuster notes, social media, and medical records don’t match up, medical canvassing fills in the blanks.
• Supporting Early Claims Decisions: A well-timed canvass prevents wasted medical spend by revealing the true scope and timing of treatment early in the life of a claim.

Want strong medical canvassing support? Connect with our team today. 

Check out our sources:

“Electronic Health Record Use Among Office-Based Physicians: United States, 2023.” CDC.gov, 2024, https://www.cdc.gov/nchs/data.

“Hospital Capabilities to Exchange Clinical Information Electronically, 2023.” HealthIT.gov, 2024, https://www.healthit.gov/data.

“The Role of Data and Technology in Modern Insurance Investigations.” NAIC.org, 2023, https://content.naic.org.

“The State of Insurance Fraud Technology: 2024 Update.” InsuranceFraud.org, 2024, https://insurancefraud.org.

“What Is Medical Canvassing and How Does It Work?” LegalClarity, 20 Aug. 2025, https://legalclarity.org/what-is-medical-canvassing-and-how-does-it-work/ .