Canvas is a programmable EMR, offering e-prescribing, a FHIR API, a Python SDK, 650+ clinical and operational events, and an extensions marketplace.

This guide covers the three ways Canvas organizations get medication PAs done.

What Canvas Gives You for Prior Authorization Out of the Box

Canvas handles prescribing through Surescripts. Before a provider can prescribe, they must enroll with Surescripts for e-prescribing and DrFirst for controlled substances. Once live, prescribers work through Canvas's medication commands for prescribing, adjusting, refilling, and handling pharmacy requests, with transmission errors surfacing as Surescripts or pharmacy rejections on the command itself. 

The FHIR API and OAuth 2.0 client credentials flow let external systems read and write chart data. The SDK, a Python package for building plugins, hooks into hundreds of platform events. And the extensions marketplace carries a Prior Authorization category alongside Benefits Verification and Denial Management.

The 3 Ways to Do Prior Authorizations in Canvas

Option 1: Manual PAs Through Task Queues and Payer Portals

A provider prescribes, the pharmacy hits a rejection, and a staff member picks up the work in CoverMyMeds, a payer portal, or on a fax machine. 

This works, and for low volumes, it might not be too much of a burden. A practice doing thirty PAs a month needs one person and an organized process. Canvas's task and banner primitives are good enough to build a tidy manual process, and plenty of teams run this way for years.

The costs show up with scale. Canvas's own guidance notes that standard requests typically run 3-5 business days once the insurer has complete documentation, and that missing information resets the clock. Every hour of that is staff time, and denials climb as volume outpaces the team's familiarity with each payer's criteria.

Best for: Practices under roughly 30 PAs per month, or any team still learning where its PA volume concentrates.

Where it is limited: Headcount scales linearly with prescription volume. There's no leverage in this model at all.

Option 2: Build Your Own PA Workflow on the Canvas SDK

Canvas is unusual among EMRs for making this a real option. The SDK is a Python package for building plugins that run in an open-source runtime, canvas init creates a project in seconds, and plugins can listen to platform events, write data, and render custom UI inside the chart.

At Canvas's 2026 Build event, teams shipped working plugins in a day, including one that generates a prior-authorization letter pre-populated from the current chart. If your PA problem is narrow and specific, this is a legitimate afternoon of work.

However, the difference between a letter generator and a PA system is significant: maintaining payer form libraries that change without notice, building submission paths for payers with no electronic rail, parsing determinations, and handling appeals. That's a whole product, that one of your engineers will own forever while your actual product waits.

Best for: Teams with real engineering capacity and a workflow so unusual that no vendor fits, or teams automating one narrow slice (a letter, a status banner, an intake questionnaire) on top of another option.

Where it is limited: You've acquired a permanent maintenance obligation in a domain that changes constantly and isn't your differentiator.

Option 3: Install a Purpose-Built PA Extension

The third option is installing something already built for Canvas. Develop Health's prior authorization integration is listed in the Canvas marketplace, published openly through the Medical Software Foundation repository, and deployed in Canvas's Weight Management & Cardiometabolic Health EMR.

Canvas describes it in their own words, in their cardiology workflow guide: the integration automates benefit verification and prior authorization requests within the Canvas workflow.

Here’s what the extension covers:

• AI form filling that eliminates searching through patient charts for the evidence a payer wants
  
  

• Automatic form selection driven by the patient's insurance information, removing the "which form does this plan use this quarter" problem
  
  

• Determination parsing that sorts responses into actionable next steps rather than a PDF someone has to read
  
  

• Automated payer follow-up when no response arrives in a reasonable window

The Develop Health platform runs the full pharmacy-benefit cycle: benefit verification, AI form autofill with supporting evidence attached, submission through whichever channel works for a given payer (ePA, AI phone calls, fax, or direct PBM portals, which gets us to 99%+ plan coverage against an ePA-only industry norm of roughly 80%), automated follow-up, denial analysis, and AI-generated appeal letters.

Customers report an 83% reduction in PA handling time, a 14% boost in approval rates, and prescription-to-approval cycle times cut from 1.5 weeks to approximately 20 hours, at a scale of hundreds of thousands of patients each month. In a case study Canvas publishes on its own extension listing, form fill times fell by nearly 50% at Sunrise. Arches Primary Care processed roughly 800 prior authorizations in six weeks, cutting turnaround from weeks to two days.

Best for: 

• Practices with high pharmacy-benefit PA volumes, especially those managing specialty medications like GLP-1s, biologics, or ADHD drugs.
  
  

• Also a strong fit for digital health companies, specialty pharmacies and any practice that wants to eliminate PA-related staff overhead without replacing tools or changing how providers prescribe.

Where it is limited:

• Develop Health focuses primarily on pharmacy-benefit PAs, it is not the right solution if your primary volume is medical-benefit authorization (procedures, imaging, referrals)

What Installing the Develop Health Extension Involves

The extension handles the Canvas side. Underneath, the Develop Health API exposes the moving parts your team configures: a base URL at api.develophealth.ai, bearer token authentication, and endpoints for running benefit verifications and submitting prior authorizations. Webhooks push asynchronous results back as determinations land, so statuses arrive in Canvas rather than requiring anyone to poll a dashboard.

The API surface is more specific than most PA vendors expose, which matters if you're extending it. The documentation index lists endpoints for checking clinical eligibility before a request goes out, identifying the correct PBM for a patient, and updating the preferred pharmacy NCPDP ID on a prescription transfer, the last of which is only permitted while the request is still active and no transfer has been attempted.

Providers keep prescribing exactly as they do today.

Side-by-Side: PA Options in Canvas

Automate the PAs Canvas Leaves to Your Staff

Canvas gives you a very good foundation, and for narrow problems the SDK can be the right answer. However, the work that burns staff hours (evidence gathering for specialty drugs, payers with no electronic rail, chasing determinations, writing appeals, etc.) sits outside the scope of what any base platform automates.

Develop Health automates the complete pharmacy-benefit cycle inside your existing Canvas workflow, with no change to how providers prescribe. Book a demo to see it in action!

Frequently Asked Questions

Does Canvas Medical have built-in prior authorization?

Not as a complete workflow. Canvas provides the components (e-prescribing, task queues, a FHIR API, and the Canvas SDK) and organizations assemble a PA process from them. Canvas has described a prior authorization agent in active customer pilots, but the automation available to most customers today comes from marketplace extensions rather than base platform functionality.

How do I automate prior authorizations in Canvas?

Three practical routes: keep it manual with well-organized task queues, build a custom workflow with the Canvas SDK, or install a purpose-built extension. The Develop Health prior authorization integration is listed in the Canvas marketplace and covers AI form filling, automatic form selection, determination parsing and automated payer follow-up; benefit verification and AI-generated appeals come from the wider platform behind it.

Can I build a prior authorization workflow with the Canvas SDK?

Yes, and teams have. At Canvas's 2026 Build event, a group shipped a prior-auth letter generator pre-populated from chart context in one day. The realistic caveat is that a single-purpose plugin is very different from an end-to-end system: payer form libraries, submission rails, determination parsing, and appeals each represent substantial ongoing engineering.

How long does a prior authorization take in Canvas?

That depends on the path, not the EMR. Canvas notes standard requests generally take 3-5 business days once the payer has complete documentation, with urgent requests reviewed in 24-72 hours. End-to-end automation platforms report cutting the full prescription-to-approval cycle to roughly 20 hours.

Does Develop Health integrate with Canvas Medical?

Yes. The integration is published in the Canvas extensions marketplace, available openly through the Medical Software Foundation repository, and deployed in Canvas's Weight Management & Cardiometabolic Health EMR. Canvas describes it as automating benefit verification and prior authorization requests within the Canvas workflow.