Difference between revisions of "Service Provider Integration"

Revision as of 00:45, 30 March 2012

This article provides an overview of the process to integrate third party service providers such as providers of transportation and translation services with instances of SmartSimple used by clients tracking Independent Medical Assessments(IME) and Rehabilitation services.

Overview

The objectives of this integration are twofold:

Provide the ability for a SmartSimple client to electronically request services from a third party provider.
Provide the ability for a third party provider to post invoice details related to the services requested back to the SmartSimple client.

Two service types are currently fully defined and supported: Interpretation/Translation and Transportation. Additional service types will be supported in the future.

The general transfer process is illustrated below:

From SmartSimple, information related to the service request is transferred to the service provider's website using a HTTPS post method
Information from the service provider's system is posted back to SmartSimple using a HTTPS post method

Transferring Information from SmartSimple to Service Provider

The information to be transferred from SmartSimple is gathered from a number of linked objects associated to the service.

As illustrated below, information is gathered from the Payor, Client's contact record, Case (Level 1), and the specific assessment or treatment service (Level 2).

The configuration work required to post information to the service provider is performed by SmartSimple or its business partners.

For a complete list of fields transferred from SmartSimple, please refer to Service Provider Integration fields page.

Transferring Information from Service Provider to SmartSimple

When invoice information is received from the Service Provider, a new record is created under each service called a service billing record (Level 3).

This service billing record contains the details and costs of the services provided.

The configuration work required to post information to SmartSimple is performed by the service provider.

For a complete list of fields transferred by the Service Provider, please refer to Service Provider Integration fields page.

Transfer Process

For security and auditing purposes, information is not directly passed from the Service Provider system to SmartSimple's client interface. Instead the returned service billing information is managed by SmartSimple's Integration Gateway.

The gateway performs the following:

Manages all incoming service billing information
Each SmartSimple client instance polls the Integration Gateway and extracts Service Billing records using proprietary protocols
All fields are submitted by http POST parameters
Service URL is https://integration.smartsimple.biz/billingpost/

Sample POST from SmartSimple

<html>
<head>
</head>
<body bgcolor="#FFFFFF" link=blue vlink=purple class="Normal" lang=EN-US topmargin="25" bottommargin="25" leftmargin="30" rightmargin="30">

//HTTP Post details
<form method="POST" action="/ex/ex_post.jsp">
<input type=hidden name="post_url" value="@system. url@">
<input type=hidden name="codedid" value="@codedid@">
<input type=hidden name="update_fieldid" value="99999">
<BR>
   <table>
<tr><th>Service</th><th><select name=ss_service><option value=2>Transportation</option></select></th>
</tr>
<tr>

//Referral Information
<th colspan="6" align="left" class="titleText001">Claim Referred By:</th>  </tr>
<tr>  <th align="left"> Address </th><td><textarea name=ss_ReferralAddress readonly>@parent.client.address@</textarea></td>
<th align="left"> City </th><td><textarea name=ss_ReferralCity readonly>@parent.client.city@</textarea></td></tr>
<tr>  <th align="left"> Province </th><td><textarea name=ss_ReferralProvince/State readonly>@parent.client.province@</textarea></td>
<th align="left"> Postal Code </th><td><textarea name=ss_ReferralPostalCode readonly>@parent.client.postalcode@</textarea></td></tr>
<tr>  <th align="left"> Phone </th><td><textarea name=ss_ReferralPHoneNumber readonly>@parent.client.phone@</textarea></td>
<th align="left"> Company </th><td><textarea name=ss_ReferralCompany readonly>@parent.company.name@</textarea></td></tr>

//File Information
<th colspan="6" align="left" class="titleText001">File  Information    </th></tr>
<tr> <th align="left">File Number (Referral)</th><td><textarea name=ss_ReferralFileNumber readonly>@parent.File Number@</textarea></td>
  <th align="left"> Type of File</th><td><textarea name=ss_ClaimFile readonly>@filetype.combovalue@</textarea></td></tr>

//Appointment Details
  <th align="left">Location</th><td><textarea name=ss_AppointmentLocation readonly>@Location@</textarea></td>
<th align="left"> Date & Time </th><td><textarea name=ss_DateandTime readonly>@fullstartdate@</textarea></td></tr>
<th align="left"> Assessment Type</th><th><textarea name=ss_TypeofAssessment readonly>@type@</textarea></th></tr>

//Claimant Information
<th colspan="6" align="left" class="titleText001">Claimant Information    </th></tr>
<tr>  <th align="left"> Claimant First Name </th><td><textarea name=ss_ClaimantFirstName readonly>@parent.Claimant First Name@</textarea></td>
<th align="left"> Claimant Last Name</th><td><textarea name=ss_ClaimantLastName readonly>@parent.Claimant Last Name@</textarea></td></tr>
<tr><th align="left"> Address </th><td><textarea name=ss_ClaimantAddress readonly>@parent.Claimant Address@</textarea></td>
  <th align="left"> City </th><td><textarea name=ss_ClaimantCity readonly>@parent.Claimant City@</textarea></td></tr>
<tr><th align="left"> Province </th><td><textarea name=ss_ClaimantProvince/State readonly>@parent.Claimant Province@</textarea></td><th> </th>
</tr><tr>  <th align="left"> Postal Code </th><td><textarea name=ss_ClaimantPostalCode readonly>@parent.Claimant Postal Code@</textarea></td>
<tr>  <th align="left">Phone </th><td><textarea name=ss_ClaimantPhone readonly>@parent.Claimant Phone #@</textarea></td></tr>

//Appointment Details
<tr>    <th colspan="6" align="left" class="titleText001">Appointment Details    </th></tr>
  <th align="left"> Appointment location same as home address</th><th><textarea name=ss_picsamehome readonly>@picsamehome.combovalue@</textarea></th></tr>
  <tr>  <th align="left"> Appointment Date and Time</th><td><textarea name=ss_DateandTime readonly>@fullstartdate@</textarea></td>
<th align="left"> Pickup Time</th><td><textarea name=ss_PickupTime readonly>@apppictime@</textarea></td></tr>
<tr>  <th align="left"> Return Time</th><td><textarea name=ss_apprettime readonly>@appdate@</textarea></td>
<th align="left"> Duration</th><td><textarea name=ss_Duration readonly>@Assessment Duration@</textarea></td></tr>
<!--@sslogic('@picsamehome@'!='Yes')-->
<tr>  <th align="left"> Address</th><td><textarea name=ss_AppointmentLocation readonly>@Location@</textarea></td>
  </tr>
<!--@end-->

//Billing Details
<tr>  <th colspan="6" align="left" class="titleText001">Billing Details</th>
</tr><tr>  <th align="left"> Billing same as referral</th>
  <td><textarea name=ss_Billingsameasreferral readonly>@billsamereferral.combovalue@</textarea></td>
</tr>
<!--@sslogic('@billsamereferral@'='No')-->
<tr>  <th align="left"> First Name (Billing)</th><td><textarea name=ss_BillingFirstName readonly>@bilfirstname@</textarea></td>
<th align="left"> Last Name (Billing)</th><td><textarea name=ss_BillingLastName readonly>@bilastname@</textarea></td></tr>
<tr>  <th align="left"> Company (Billing)</th><td><textarea name=ss_BillingCompany readonly>@bilcompany@</textarea></td>
<th align="left"> Address (Billing)</th><td><textarea name=ss_BillingAddress readonly>@biladdress@</textarea></td></tr>
<tr>  <th align="left"> City (Billing)</th><td><textarea name=ss_BillingCity readonly>@bilcity@</textarea></td>
<th align="left"> Province Code/Zip (Billing)</th><td><textarea name=ss_BillingProvince/State readonly>@bilprovince@</textarea></td></tr>
<tr>    <th align="left"> Postal Code/Zip (Billing)</th><td><textarea name=ss_BillingPostalCode readonly>@bilzip@</textarea></td>
<!--@end-->

//Appointment Confirmation
<tr>  <th colspan="6" align="left" class="titleText001">Appointment Confirmation</th>
</tr><th align="left"> Fax confirmation of appointment</th><th><textarea name=ss_Faxconfirmationofappointment readonly>@faxconf.combovalue@</textarea></th><th> </th>
 <th align="left"> Phone Confirmation</th><th><textarea name=ss_Phoneconfirmationofappointment readonly>@phoneconf.combovalue@</textarea></th></tr>
<tr>  <th align="left"> Email confirmation of web referral</th><td><textarea name=ss_Emailconfirmationofappointment readonly>@emailconf.combovalue@</textarea></td></tr>
</table>
</div>
</form>
 </body>
</html>

Difference between revisions of "Service Provider Integration"

Revision as of 00:45, 30 March 2012

Contents

Overview

Transferring Information from SmartSimple to Service Provider

Transferring Information from Service Provider to SmartSimple

Transfer Process

Sample POST from SmartSimple

Navigation menu

Personal tools

Namespaces

Variants

Views

More

Search

Navigation

Tools

@@ Line 5: / Line 5: @@
 *Provide the ability for a third party provider to post invoice details related to the services requested back to the SmartSimple client.
-Two service types are currently fully defined and supported: <b>Interpretation/Translation</b> and <b>Transportation</b>. Additional service types will be supported in the future.
+Two service types are currently fully defined and supported: '''Interpretation/Translation''' and '''Transportation'''. Additional service types will be supported in the future.
-The process is illustrated below:
+The general transfer process is illustrated below:
+[[File:1_Transfer_Process.PNG]]
+*From SmartSimple, information related to the service request is transferred to the service provider's website using a [[Post to External Server|HTTPS post method]]
+*Information from the service provider's system is posted back to SmartSimple using a HTTPS post method
 ===Transferring Information from SmartSimple to Service Provider===
+----
+The information to be transferred from SmartSimple is gathered from a number of linked objects associated to the service.
+As illustrated below, information is gathered from the Payor, Client's contact record, Case ('''''Level 1'''''), and the specific assessment or treatment service ('''''Level 2''''').
+[[File:2_SmartSimple_Objects.PNG]]
+*The configuration work required to post information to the service provider is performed by SmartSimple or its business partners.
+'''For a complete list of fields transferred from SmartSimple, please refer to [[Service Provider Integration fields]] page.'''
 ===Transferring Information from Service Provider to SmartSimple===
-==Field List transferred to Service Provider System==
-As part of our Integration services, we currently support <u>two types of transaction records</u>.
+----
-*Interpretation records - Identified by <b>TypeofService</b> field - set to 1.
+When invoice information is received from the Service Provider, a new record is created under each service called a service billing record ('''''Level 3''''').
-*Transportation records - Identified by <b>TypeofService</b> field - set to 2.
+This service billing record contains the details and costs of the services provided.
+[[File:3_Service_Provider_Objects.PNG]]
+*The configuration work required to post information to SmartSimple is performed by the service provider.
-Referring to the list below, note that both Interpretation and Transportation records have common fields until <b>Field #55</b>.
+'''For a complete list of fields transferred by the Service Provider, please refer to [[Service Provider Integration fields]] page.'''
-===Interpretation Fields===
-{| border="1" cellpadding="4"
-|-
-! style="color: black; background-color: #62BC43;"|Identifiers !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-| 1 || CaseID || Unique Identifier for Case || Numberic ||
-|-
-| 2 || ServiceID || Unique Identifier for Service || Numberic ||
-|-
-| 3 || CustomerID || Unique Identifier for SmartSimple Customer || Alpha ||
-|-
-| 4 || Source || Source Type || Numberic || 10=IME , 20=Insurer
-|-
-| 5 || TypeofService || Type of Service || Numeric || <b>1</b>
-|-
-| 6 || ProtocolPassword || Protocol Password || ||
-|-
-! style="color: black; background-color: #62BC43;"|Referral !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|7||ReferralFirstName||Referral First Name||Alpha||
-|-
-|8||ReferralLastName||Referral Last Name||Alpha||
-|-
-|9||ReferralAddress||Referral Address||Alpha||
-|-
-|10||ReferralCity||Referral City||Alpha||
-|-
-|11||ReferralProvince/State||Referral Province/State||Alpha||
-|-
-|12||ReferralPostalCode||Referral PostalCode||Alpha||
-|-
-|13||ReferralCountry||Referral Country||Alpha||
-|-
-|14||ReferralFileNumber||Referral FileNumber||Alpha||
-|-
-|15||ReferralPhoneNumber||Referral Phone Number||Alpha||
-|-
-|16||ReferralFaxNumber||Referral Fax Number||Alpha||
-|-
-|17||ReferralEmail||Referral Email||Alpha||
-|-
-|18||ReferralCompany||Referral Company||Alpha||
-|-
-! style="color: black; background-color: #62BC43;"|Claimant !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|19||ClaimantFirstName||Claimant First Name||Alpha||
-|-
-|20||ClaimantLastName||Claimant Last Name||Alpha||
-|-
-|21||ClaimantApt/Suite||Claimant Apt/Suite||Alpha||
-|-
-|22||ClaimantBuzzer||Claimant Buzzer||Alpha||
-|-
-|23||ClaimantAddress||Claimant Address||Alpha||
-|-
-|24||ClaimantCity||Claimant City||Alpha||
-|-
-|25||ClaimantProvince/State||Claimant Province/State||Alpha||
-|-
-|26||ClaimantPostalCode||Claimant PostalCode||Alpha||
-|-
-|27||ClaimantCountry||Claimant Country||Alpha||
-|-
-|28||ClaimantPhone||Claimant Phone||Alpha||
-|-
-|29||ClaimantFax||Claimant Fax||Alpha||
-|-
-|30||ClaimFile||Claim File||Alpha||
-|-
-|31||DateofLoss||Dateof Loss||Date/Time||YYYY-MM-DD
-|-
-|32||ClaimantPolicyNumber||Claimant Policy Number||Alpha||
-|-
-|33||ClaimantP.O.Box||Claimant P.O. Box||Alpha||
-|-
-|33||Billingsameasreferral||Billing same as referral||Numeric||1=Yes;2=No
-|-
-! style="color: black; background-color: #62BC43;"|Billing !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|34||BillingFirstName||Billing First Name||Alpha||
-|-
-|35||BillingLastName||Billing Last Name||Alpha||
-|-
-|36||BillingCompany||Billing Company||Alpha||
-|-
-|37||BillingAddress||Billing Address||Alpha||
-|-
-|38||BillingCity||Billing City||Alpha||
-|-
-|39||BillingProvince/State||Billing Province/State||Alpha||
-|-
-|40||BillingPostalCode||Billing Postal Code||Alpha||
-|-
-|41||BillingPhone||Billing Phone||Alpha||
-|-
-|42||BillingFax||Billing Fax||Alpha||
-|-
-|43||BillingEmail||Billing Email||Alpha||
-|-
-|44||BillingP.O.Box||Billing P.O. Box||Alpha||
-|-
-! style="color: black; background-color: #62BC43;"|Appointment Details !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|45||Faxconfirmationofappointment||Fax confirmation of appointment||Numeric||1=Yes;2=No
-|-
-|46||Emailconfirmationofappointment||Email confirmation of appointment||Numeric||1=Yes;2=No
-|-
-|47||Phoneconfirmationofappointment||Phone confirmation of appointment||Numeric||1=Yes;2=No
-|-
-|48||Notes||Notes||Alpha||
-|-
-|49||ArrangeAppointmentwithclaimant||Arrange Appointment with claimant/patient||Numeric||1=Yes;2=No
-|-
-|50||ConfirmAppointmentwithclaimant||Confirm Appointment with claimant/patient||Numeric||1=Yes;2=No
-|-
-|51||DateandTime||Date and Time of appointment||Date/Time||YYYY-MM-DDHH:MM:SS
-|-
-|52||Duration||Duration||Date/Time||hh:mm
-|-
-|53||AppointmentLocation||Location||Alpha||
-|-
-|54||TypeofAssessment||Type of Assessment||Alpha||
-|-
-|55||Language||Language||Alpha||
-|-
-|56||GenderofInterpreter||Gender of Interpreter||Numeric||1=Male;2=Female;3=NoPreferences
-|}
+===Transfer Process===
 ----
-===Transportation Fields===
+For security and auditing purposes, information is not directly passed from the Service Provider system to SmartSimple's client interface. Instead the returned service billing information is managed by SmartSimple's [[HCAI Overview|Integration Gateway]].
-{| border="1" cellpadding="4"
-|-
+[[File:4_Integration_Gateway.PNG]]
-! style="color: black; background-color: #62BC43;"|Identifiers !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
+The gateway performs the following:
-| 1 || CaseID || Unique Identifier for Case || Numberic ||
+*Manages all incoming service billing information
-|-
+*Each SmartSimple client instance polls the Integration Gateway and extracts Service Billing records using proprietary protocols
-| 2 || ServiceID || Unique Identifier for Service || Numberic ||
+*All fields are submitted by http POST parameters
-|-
+*Service URL is https://integration.smartsimple.biz/billingpost/
-| 3 || CustomerID || Unique Identifier for SmartSimple Customer || Alpha ||
-|-
-| 4 || Source || Source Type || Numberic || 10=IME , 20=Insurer
-|-
+==Sample POST from SmartSimple==
-| 5 || TypeofService || Type of Service || Numeric || <b>2</b>
-|-
+----
-| 6 || ProtocolPassword || Protocol Password || ||
-|-
-! style="color: black; background-color: #62BC43;"|Referral !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|7||ReferralFirstName||Referral First Name||Alpha||
-|-
-|8||ReferralLastName||Referral Last Name||Alpha||
-|-
-|9||ReferralAddress||Referral Address||Alpha||
-|-
-|10||ReferralCity||Referral City||Alpha||
-|-
-|11||ReferralProvince/State||Referral Province/State||Alpha||
-|-
-|12||ReferralPostalCode||Referral PostalCode||Alpha||
-|-
-|13||ReferralCountry||Referral Country||Alpha||
-|-
-|14||ReferralFileNumber||Referral FileNumber||Alpha||
-|-
-|15||ReferralPhoneNumber||Referral Phone Number||Alpha||
-|-
-|16||ReferralFaxNumber||Referral Fax Number||Alpha||
-|-
-|17||ReferralEmail||Referral Email||Alpha||
-|-
-|18||ReferralCompany||Referral Company||Alpha||
-|-
-! style="color: black; background-color: #62BC43;"|Claimant !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|19||ClaimantFirstName||Claimant First Name||Alpha||
-|-
-|20||ClaimantLastName||Claimant Last Name||Alpha||
-|-
-|21||ClaimantApt/Suite||Claimant Apt/Suite||Alpha||
-|-
-|22||ClaimantBuzzer||Claimant Buzzer||Alpha||
-|-
-|23||ClaimantAddress||Claimant Address||Alpha||
-|-
-|24||ClaimantCity||Claimant City||Alpha||
-|-
-|25||ClaimantProvince/State||Claimant Province/State||Alpha||
-|-
-|26||ClaimantPostalCode||Claimant PostalCode||Alpha||
-|-
-|27||ClaimantCountry||Claimant Country||Alpha||
-|-
-|28||ClaimantPhone||Claimant Phone||Alpha||
-|-
-|29||ClaimantFax||Claimant Fax||Alpha||
-|-
-|30||ClaimFile||Claim File||Alpha||
-|-
-|31||DateofLoss||Dateof Loss||Date/Time||YYYY-MM-DD
-|-
-|32||ClaimantPolicyNumber||Claimant Policy Number||Alpha||
-|-
-|33||ClaimantP.O.Box||Claimant P.O. Box||Alpha||
-|-
-|33||Billingsameasreferral||Billing same as referral||Numeric||1=Yes;2=No
-|-
-! style="color: black; background-color: #62BC43;"|Billing !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|34||BillingFirstName||Billing First Name||Alpha||
-|-
-|35||BillingLastName||Billing Last Name||Alpha||
-|-
-|36||BillingCompany||Billing Company||Alpha||
-|-
-|37||BillingAddress||Billing Address||Alpha||
-|-
-|38||BillingCity||Billing City||Alpha||
-|-
-|39||BillingProvince/State||Billing Province/State||Alpha||
-|-
-|40||BillingPostalCode||Billing Postal Code||Alpha||
-|-
-|41||BillingPhone||Billing Phone||Alpha||
-|-
-|42||BillingFax||Billing Fax||Alpha||
-|-
-|43||BillingEmail||Billing Email||Alpha||
-|-
-|44||BillingP.O.Box||Billing P.O. Box||Alpha||
-|-
-! style="color: black; background-color: #62BC43;"|Appointment Details !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|45||Faxconfirmationofappointment||Fax confirmation of appointment||Numeric||1=Yes;2=No
-|-
-|46||Emailconfirmationofappointment||Email confirmation of appointment||Numeric||1=Yes;2=No
-|-
-|47||Phoneconfirmationofappointment||Phone confirmation of appointment||Numeric||1=Yes;2=No
-|-
-|48||Notes||Notes||Alpha||
-|-
-|49||ArrangeAppointmentwithclaimant||Arrange Appointment with claimant/patient||Numeric||1=Yes;2=No
-|-
-|50||ConfirmAppointmentwithclaimant||Confirm Appointment with claimant/patient||Numeric||1=Yes;2=No
-|-
-|51||DateandTime||Date and Time of appointment||Date/Time||YYYY-MM-DDHH:MM:SS
-|-
-|52||Duration||Duration||Date/Time||hh:mm
-|-
-|53||AppointmentLocation||Location||Alpha||
-|-
-|54||TypeofAssessment||Type of Assessment||Alpha||
-|-
-! style="color: black; background-color: #62BC43;"|Pickup Details !! style="color: black; background-color: #62BC43;"|Field Name !! style="color: black; background-color: #62BC43;"|Description !! style="color: black; background-color: #62BC43;"|Field Type !! style="color: black; background-color: #62BC43;"|Acceptable Values
-|-
-|55||PickupTime||Pickup Time||Date/Time||YYYY-MM-DDHH:MM:SS
-|-
-|56||PickupAddress||Pickup Address||Alpha||
-|-
-|57||PickupCity||Pickup City||Alpha||
-|-
-|58||PickupPostalCode||Postal Code||Alpha||
-|-
-|59||PickupApt/Suite||Pickup Apt/Suite||Alpha||
-|-
-|60||PickupBuzzer||Pickup Buzzer||Alpha||
-|-
-|61||PickupProvince/State||Pickup Province/State||Alpha||
-|-
-|62||PickupPhone||Pickup Phone||Alpha||
-|-
-|63||WheelchairVehicle||Does claimant require a wheelchair accessible vehicle?||Numeric|| 1=Yes;2=No
-|-
-|64||SpecialNeeds||Does claimant require special needs (e.g. Assistance)?||Numeric||1=Yes;2=No
-|}
-==Field List transferred to SmartSimple==
-==Sample Code==
 <pre>
-test
+<html>
+<head>
+</head>
+<body bgcolor="#FFFFFF" link=blue vlink=purple class="Normal" lang=EN-US topmargin="25" bottommargin="25" leftmargin="30" rightmargin="30">
+//HTTP Post details
+<form method="POST" action="/ex/ex_post.jsp">
+<input type=hidden name="post_url" value="@system. url@">
+<input type=hidden name="codedid" value="@codedid@">
+<input type=hidden name="update_fieldid" value="99999">
+<BR>
+   <table>
+<tr><th>Service</th><th><select name=ss_service><option value=2>Transportation</option></select></th>
+</tr>
+<tr>
+//Referral Information
+<th colspan="6" align="left" class="titleText001">Claim Referred By:</th>  </tr>
+<tr>  <th align="left"> Address </th><td><textarea name=ss_ReferralAddress readonly>@parent.client.address@</textarea></td>
+<th align="left"> City </th><td><textarea name=ss_ReferralCity readonly>@parent.client.city@</textarea></td></tr>
+<tr>  <th align="left"> Province </th><td><textarea name=ss_ReferralProvince/State readonly>@parent.client.province@</textarea></td>
+<th align="left"> Postal Code </th><td><textarea name=ss_ReferralPostalCode readonly>@parent.client.postalcode@</textarea></td></tr>
+<tr>  <th align="left"> Phone </th><td><textarea name=ss_ReferralPHoneNumber readonly>@parent.client.phone@</textarea></td>
+<th align="left"> Company </th><td><textarea name=ss_ReferralCompany readonly>@parent.company.name@</textarea></td></tr>
+//File Information
+<th colspan="6" align="left" class="titleText001">File  Information    </th></tr>
+<tr> <th align="left">File Number (Referral)</th><td><textarea name=ss_ReferralFileNumber readonly>@parent.File Number@</textarea></td>
+  <th align="left"> Type of File</th><td><textarea name=ss_ClaimFile readonly>@filetype.combovalue@</textarea></td></tr>
+//Appointment Details
+  <th align="left">Location</th><td><textarea name=ss_AppointmentLocation readonly>@Location@</textarea></td>
+<th align="left"> Date & Time </th><td><textarea name=ss_DateandTime readonly>@fullstartdate@</textarea></td></tr>
+<th align="left"> Assessment Type</th><th><textarea name=ss_TypeofAssessment readonly>@type@</textarea></th></tr>
+//Claimant Information
+<th colspan="6" align="left" class="titleText001">Claimant Information    </th></tr>
+<tr>  <th align="left"> Claimant First Name </th><td><textarea name=ss_ClaimantFirstName readonly>@parent.Claimant First Name@</textarea></td>
+<th align="left"> Claimant Last Name</th><td><textarea name=ss_ClaimantLastName readonly>@parent.Claimant Last Name@</textarea></td></tr>
+<tr><th align="left"> Address </th><td><textarea name=ss_ClaimantAddress readonly>@parent.Claimant Address@</textarea></td>
+  <th align="left"> City </th><td><textarea name=ss_ClaimantCity readonly>@parent.Claimant City@</textarea></td></tr>
+<tr><th align="left"> Province </th><td><textarea name=ss_ClaimantProvince/State readonly>@parent.Claimant Province@</textarea></td><th> </th>
+</tr><tr>  <th align="left"> Postal Code </th><td><textarea name=ss_ClaimantPostalCode readonly>@parent.Claimant Postal Code@</textarea></td>
+<tr>  <th align="left">Phone </th><td><textarea name=ss_ClaimantPhone readonly>@parent.Claimant Phone #@</textarea></td></tr>
+//Appointment Details
+<tr>    <th colspan="6" align="left" class="titleText001">Appointment Details    </th></tr>
+  <th align="left"> Appointment location same as home address</th><th><textarea name=ss_picsamehome readonly>@picsamehome.combovalue@</textarea></th></tr>
+  <tr>  <th align="left"> Appointment Date and Time</th><td><textarea name=ss_DateandTime readonly>@fullstartdate@</textarea></td>
+<th align="left"> Pickup Time</th><td><textarea name=ss_PickupTime readonly>@apppictime@</textarea></td></tr>
+<tr>  <th align="left"> Return Time</th><td><textarea name=ss_apprettime readonly>@appdate@</textarea></td>
+<th align="left"> Duration</th><td><textarea name=ss_Duration readonly>@Assessment Duration@</textarea></td></tr>
+<!--@sslogic('@picsamehome@'!='Yes')-->
+<tr>  <th align="left"> Address</th><td><textarea name=ss_AppointmentLocation readonly>@Location@</textarea></td>
+  </tr>
+<!--@end-->
+//Billing Details
+<tr>  <th colspan="6" align="left" class="titleText001">Billing Details</th>
+</tr><tr>  <th align="left"> Billing same as referral</th>
+  <td><textarea name=ss_Billingsameasreferral readonly>@billsamereferral.combovalue@</textarea></td>
+</tr>
+<!--@sslogic('@billsamereferral@'='No')-->
+<tr>  <th align="left"> First Name (Billing)</th><td><textarea name=ss_BillingFirstName readonly>@bilfirstname@</textarea></td>
+<th align="left"> Last Name (Billing)</th><td><textarea name=ss_BillingLastName readonly>@bilastname@</textarea></td></tr>
+<tr>  <th align="left"> Company (Billing)</th><td><textarea name=ss_BillingCompany readonly>@bilcompany@</textarea></td>
+<th align="left"> Address (Billing)</th><td><textarea name=ss_BillingAddress readonly>@biladdress@</textarea></td></tr>
+<tr>  <th align="left"> City (Billing)</th><td><textarea name=ss_BillingCity readonly>@bilcity@</textarea></td>
+<th align="left"> Province Code/Zip (Billing)</th><td><textarea name=ss_BillingProvince/State readonly>@bilprovince@</textarea></td></tr>
+<tr>    <th align="left"> Postal Code/Zip (Billing)</th><td><textarea name=ss_BillingPostalCode readonly>@bilzip@</textarea></td>
+<!--@end-->
+//Appointment Confirmation
+<tr>  <th colspan="6" align="left" class="titleText001">Appointment Confirmation</th>
+</tr><th align="left"> Fax confirmation of appointment</th><th><textarea name=ss_Faxconfirmationofappointment readonly>@faxconf.combovalue@</textarea></th><th> </th>
+ <th align="left"> Phone Confirmation</th><th><textarea name=ss_Phoneconfirmationofappointment readonly>@phoneconf.combovalue@</textarea></th></tr>
+<tr>  <th align="left"> Email confirmation of web referral</th><td><textarea name=ss_Emailconfirmationofappointment readonly>@emailconf.combovalue@</textarea></td></tr>
+</table>
+</div>
+</form>
+ </body>
+</html>
 </pre>
 [[Category:Universal Tracking Application]][[Category:Integration]]