Changes

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

*Each SmartSimple client instance polls the Integration Gateway and extracts Service Billing records using proprietary protocols

<input type=hidden name="post_url" value="@system. urlproviderurl@"> <input type=hidden name="codedidss_CaseID" value="@codedidparent.opportunityid@"> <input type=hidden name="ss_ServiceID" value="@eventid@"> <input type=hidden name="ss_CustomerID" value="ID goes here"> <input type=hidden name="update_fieldidss_Source" value="9999910"> <BRdiv style="border:1px solid #1b409b; max-width:700px; min-width:550px;"> <table> <th colspan="4" align="left" class="titleText001">Insurance company claim referred By:</th> </tr> <tr> <th align="left">Referral Contact First Name </th> <td><textarea name=ss_ReferralFirstName readonly>@parent.Referral Contact First Name@</textarea></td> <th align="left">Referral Contact Last Name </th> <td><textarea name=ss_ReferralLastName readonly>@parent.Referral Contact Last Name@</textarea></td> </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> <thalign="left">ServiceCountry </th> <td><textarea name=ss_ReferralCountry readonly>Canada</textarea></td> </tr> <tr> <th align="left"> Phone </th> <td><select textarea name=ss_servicess_ReferralPhoneNumber readonly>@parent.Referral Contact Phone@<option value/textarea></td> <th align="left"> Fax </th> <td><textarea name=ss_ReferralFaxNumber readonly>@parent.client.fax@</textarea></td> </tr> <tr> <th align="left">Email </th> <td><textarea name=ss_ReferralEmail readonly>@parent.Referral Contact Email@</textarea></td> <th align="left"> Company </th> <td><textarea name=ss_ReferralCompany readonly>@parent.client.name@</textarea></td> </tr> <th colspan="4" align="left" class="titleText001"><br /><br />Pickup Details </th> </tr> <tr> <th align="left"> Pickup Time</th> <td><textarea name=ss_PickupTime readonly>@apppictime@</textarea></td> <th align="left"> Pickup Address</th> <td><textarea name=ss_PickupAddress readonly>@picaddress@</textarea></td> </tr> <tr> <th align="left"> Pickup City</th> <td><textarea name=ss_PickupCity readonly>@piccity@</textarea></td> <th align="left"> Pickup Postal Code</th> <td><textarea name=ss_PickupPostalCode readonly>@piczip@</textarea></td> </tr> <tr> <th align="left"> Pickup Province/State</th> <td><textarea name=ss_PickupProvince readonly>@picprovince@</textarea></td> <th align="left"> Pickup Phone</th> <td><textarea name=ss_PickupPhone readonly>@Pickup-Phone@</textarea></td> </tr> <th colspan="4" align="left" class="titleText001"><br /><br />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 readonly>@parent.Claimant Province@</textarea></td> <th align="left"> Postal Code </th> <td><textarea name=ss_ClaimantPostalCode readonly>@parent.Claimant Postal Code@</textarea></td> </tr> <tr> <th align="left"> Country </th> <td><textarea name=ss_ClaimantCountry readonly>Canada</textarea></td> <th align="left">Phone </th> <td><textarea name=ss_ClaimantPhone readonly>@parent.Claimant Phone #@</textarea></td> <tr> <th align="left">Policy #</th> <td><textarea name=2ss_ClaimantPolicyNumber readonly>Transportation@parent.Policy #@</optiontextarea></selecttd> <th align="left">Claim #</th> <td><textarea name=ss_ClaimFile readonly>@parent.Claim #@</textarea></td> </tr> <tr> <th align="left"> Date of Loss </th> <td><textarea name=ss_DateofLoss readonly>@parent.Date of Loss@</textarea></td> </tr> </table> </div></form></body></html>

//Referral Information<th colspan="6" align="left" class="titleText001">Claim Referred By:</th> </trpre><tr> <th align="left"> Address </th><td><textarea name=ss_ReferralAddress readonly>@parent.client.address@</textarea></td><th alignSample POST to SmartSimple="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.clientThe following code is a sample html post page that Service Providers can use to POST data back to SmartSimple’s Integration Server.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>@billsamereferralEach form element will need to be populated with information related to the performed service from the Service Provider’s data source.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-->

<pre><HTML><HEAD><TITLE>Integration Provider Sample Submission</TITLE></Appointment ConfirmationHEAD><trBODY> <th colspanform action="6http://hcai.smartsimple.biz/ex/provider/billing.jsp" alignmethod="leftPOST" classtarget="titleText001_blank">Appointment Confirmation <table border=1 cellspaing=0 cellpadding=1> <tr> <td width=400px>Provider Key</td> <td><textarea rows=1 cols=25 name=providerkey>xxx key goes here xxx</textarea></td> </tr> <tr> <td width=400px>Test Submission Flag</td> <td><textarea rows=1 cols=25 name=isprod>0</textarea></td> </tr> <tr> <td width=400px>Case ID</td> <td><textarea rows=1 cols=25 name=caseid>123456</textarea></td> </tr> <tr> <td width=400px>Service ID</td> <td><textarea rows=1 cols=25 name=serviceid>88888</textarea></thtd> </tr> <th aligntr> <td width="left"400px> Fax confirmation Type of appointmentService </td> <td><textarea rows=1 cols=25 name=typeofservice>typeofservice</textarea></td> </tr> <tr> <td width=400px>Client Alias </thtd> <thtd><textarea rows=1 cols=25 name=ss_Faxconfirmationofappointment readonlyclient>client</textarea></td> </tr>@faxconf <tr> <td width=400px>Client Type</td> <td><textarea rows=1 cols=25 name=source>10</textarea></td> </tr> <tr> <td width=400px>GAP Code </td> <td><textarea rows=1 cols=25 name=gapcode>gapcode</textarea></td> </tr> <tr> <td width=400px>Rate for service</td> <td><textarea rows=1 cols=25 name=rate>10.combovalue@00</textarea></td> </tr> <tr> <td width=400px>Unit Measure </td> <td><textarea rows=1 cols=25 name=measure>measure</textarea></td> </tr> <tr> <td width=400px>Quantity</td> <td><textarea rows=1 cols=25 name=quantity>quantity</textarea></td> </tr> <tr> <td width=400px>Tax</td> <td><textarea rows=1 cols=25 name=tax>tax</textarea></td> </tr> <tr> <td width=400px>Tax Type</td> <td><textarea rows=1 cols=25 name=taxtype>taxtype</textarea></td> </tr> <tr> <td width=400px>Total</td> <td><textarea rows=1 cols=25 name=total>total</textarea></td> </tr> <tr> <td width=400px>Tax Amount</td> <td><textarea rows=1 cols=25 name=taxamt>taxamt</textarea></td> </tr> <tr> <td width=400px>Gross Total</td> <td><textarea rows=1 cols=25 name=grossamt>grossamt</textarea></thtd> </tr> <tr> <thtd width=400px> Reference #</thtd> <td><th aligntextarea rows=1 cols="left"25 name=reference>reference</textarea></td> </tr> <tr> <td width=400px> Phone Confirmation#</thtd> <thtd><textarea rows=1 cols=25 name=ss_Phoneconfirmationofappointment readonlyconfirmationnum>#12345-eee</textarea>@phoneconf.combovalue@</td> </tr> <tr> <td width=400px>Provider Name</td> <td><textarea rows=1 cols=25 name=provider>provider</textarea></td> </tr> <tr> <td width=400px>Provider Emailr</td> <td><textarea rows=1 cols=25 name=provideremail>provideremail</textarea></thtd> </tr> <tr> <th aligntd width="left"400px> Email confirmation of web referralNotes</thtd> <td><textarea rows=1 cols=25 name=ss_Emailconfirmationofappointment readonlynotes>@emailconf.combovalue@notes</textarea></td> </tr> <tr> <td width=400px><Input type="submit" value="Submit to SmartSimple"></tabletd> </tr> </divtable>

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