Note States

Last updated: December 27, 2024

There are three categories of notes in Canvas:

  • Appointment requests which can be booked or canceled.

  • Appointment notes which can be checked-in, rescheduled, canceled or marked as no shows. 

  • Note Types (includes base note types and custom note types) which can be signed/locked, deleted, amended/unlocked, and can also be used to push charges.  

Billable notes are automatically associated to a claim that travels through the Canvas revenue queues. The header of any Canvas note has an indicator that displays the status of the note in real time. The footer of any Canvas note gives additional details including its location in the Canvas revenue queues and whether the note has been locked/unlocked or signed/amended. 

Tips & Tricks

  • Changes made to the status of an appointment card within the Schedule view are not reflected in the note. e.g. Marking an appointment as arrived does not automatically check in the note.

  • The note footer will display who made changes to the note as well as a timestamp in the logged in user's timezone. Of note: when printing the note timestamps are displayed in the installation timezone for that particular instance. 

  • The footer will display in which revenue queue the claim is currently located.

  • If utilizing your readonly data base, note state change events can be found in api_notestatechangeevent. Please refer to the following key for more details:

Note State Change Event

UI change description

NEW = 'NEW'

New note created

PUSHED = 'PSH'

Billing charges pushed using the Push Charges button

LOCKED = 'LKD'

Note has been locked

UNLOCKED = 'ULK'

Note has been unlocked

DELETED = 'DLT'

Note has been deleted

RESTORED = 'RST'

Note has been restored after deleting

RECALLED = 'RCL'

 

UNDELETED = 'UND'

 

DISCHARGED = 'DSC'

Inpatient note has been discharged

Appointment note statuses

UI change description

SCHEDULING = 'SCH'

Appointment is being scheduled but not booked

BOOKED = 'BKD'

Appointment has been booked

CONVERTED = 'CVD'

Appointment has been checked-in

CANCELLED = 'CLD'

Appointment has been canceled

NOSHOW = 'NSW'

Appointment has been marked as no show

REVERTED = 'RVT'

Appointment note change has been revert from the note footer

CONFIRM_IMPORT = 'CNF'

Data Import status has been confirmed

Note Header Statuses

The note header will display a gray check mark when the note content is saved. After changes are made, users will see a "Saving..." message indicating that the content is currently being saved. When the saving event has completed a "Saved" message will display followed by the gray check mark again indicating that the content is currently in saved status. If the indicator remains in the “Saving...” state for an extended period, there may be a weak connection. If the note status is displayed as "Offline", then additional content added to the note may not save to the database. 

Default Lock Functionality vs Note Restrictions

By default notes in Canvas use the Lock button to indicate when a note has been completed and the Unlock button to make edits to an already signed note. However, if your organization has Note Signature Restrictions enabled you will see a Sign Note or Amend Note button that can only be acted on by the rendering provider.

Appointment Note

When a patient appointment is scheduled in Canvas an appointment note is created. Appointment notes start off in the appointments queue in Canvas, however, this is not displayed in the note footer until the status is changed for the first time.  Status changes can be triggered using the following footer buttons:

  • Check In: Transitions appointment note to the specific note type that was scheduled also moves the associated claim from the appointments queue to the clinicians queue.

  • Reschedule: Reschedules an appointment within the same appointment note and keeps associated claim in the appointments queue.

  • Cancel: Cancel an appointment and removes the note from the timeline. This action cannot be undone by the user. The associated claim is moved to the trash queue.

  • No show: Indicates the patient did not show and drops a No-Show CPT code into the billing footer. The associated claim is moved to the clinicians queue.

An appointment note can be reverted after checking in or marking it as a no-show but the associated claim will remain in the clinician's queue.

Checked-In notes

Checking in an appointment note converts it to the specific note type that was selected when the appointment was initially booked (i.e. office visit or home visit).  While the note is being used for documentation it remains unsigned or unlocked in the clinician's queue. Claims linked to notes that originate from the New Note Button, instead of an appointment note, start off in the clinician's revenue queue as well. Once the note has been signed or locked for the first time it moves to the coding queue.

The following footer buttons can change the status of a Note:

  • Lock or Sign Note: Indicates that clinical documentation is complete, adds the rendering providers signature, and pushes charges to the claim that were added to the billing footer.

  • Push charges: Pushes all charges to the claim that were added to the billing footer and moves the associated claim to the coding queue. Used if billing documentation is complete within the note and billing footer but clinical documentation is still pending.

  • Delete: Deletes the note.

If your organization has the RESTRICT_SIGNING_NOTE_WITH_UNCOMMITTED_COMMANDS enabled the locking or signing of a note will be disabled and the following warning will be displayed until all commands within the note are committed.

Unlocking/Amending Notes

Amending or unlocking a note will leave it in its current revenue queue and allow users to edit or amend the note as needed.

Deleting Notes

Notes can be deleted in Canvas with the button. Only notes that originated as an appointment note can be restored after deleting from the UI.