Changes

The following portion of code is a sample of what SmartSimple will be using within a [[Web Page View]] on each client copy to post the details field data to the service provider.

<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> </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></tdpre> <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 alignSample POST to SmartSimple="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>@parentThe following code is a sample html post page that Service Providers can use to POST data back to SmartSimple’s Integration Server.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>@picsamehomeEach form element will need to be populated with information related to the performed service from the Service Provider’s data source.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-->

<pre><HTML><HEAD><TITLE>Integration Provider Sample Submission</TITLE></Billing DetailsHEAD><trBODY> <th colspanform action="6http://hcai.smartsimple.biz/ex/provider/billing.jsp" alignmethod="leftPOST" classtarget="titleText001_blank">Billing Details <table border=1 cellspaing=0 cellpadding=1> <tr> <td width=400px>Provider Key</thtd> <td><textarea rows=1 cols=25 name=providerkey>xxx key goes here xxx</textarea></td> </tr> <tr> <th aligntd width="left"400px> Billing same as referralTest Submission Flag</thtd> <td><textarea rows=1 cols=25 name=ss_Billingsameasreferral readonlyisprod>@billsamereferral.combovalue@0</textarea></td> </tr> <tr> <td width=400px>Case ID</td> <td><!--@sslogic('@billsamereferral@'textarea rows=1 cols=25 name='No')--caseid>123456</textarea></td> </tr> <tr> <th aligntd width="left"400px> First Name (Billing)Service ID</thtd> <td><textarea rows=1 cols=25 name=ss_BillingFirstName readonlyserviceid>@bilfirstname@88888</textarea></td> </tr> <th aligntr> <td width="left"400px> Last Name (Billing)Type of Service </thtd> <td><textarea rows=1 cols=25 name=ss_BillingLastName readonlytypeofservice>@bilastname@typeofservice</textarea></td> </tr> <tr> <th aligntd width="left"400px> Company (Billing)Client Alias </thtd> <td><textarea rows=1 cols=25 name=ss_BillingCompany readonlyclient>@bilcompany@client</textarea></td> </tr> <th aligntr> <td width="left"400px> Address (Billing)Client Type</thtd> <td><textarea rows=1 cols=25 name=ss_BillingAddress readonlysource>@biladdress@10</textarea></td> </tr> <tr> <th aligntd width="left"400px> City (Billing)GAP Code </thtd> <td><textarea rows=1 cols=25 name=ss_BillingCity readonlygapcode>@bilcity@gapcode</textarea></td> <th align/tr> <tr> <td width=400px>Rate for service</td> <td><textarea rows="left"1 cols=25 name=rate>10.00</textarea></td> Province Code </Zip (Billing)tr> <tr> <td width=400px>Unit Measure </thtd> <td><textarea rows=1 cols=25 name=ss_BillingProvincemeasure>measure</State readonlytextarea>@bilprovince@</td> </tr> <tr> <td width=400px>Quantity</td> <td><textarea rows=1 cols=25 name=quantity>quantity</textarea></td> </tr> <tr> <th aligntd width=400px>Tax</td> <td><textarea rows=1 cols=25 name="left"tax>tax</textarea> Postal Code</Zip (Billing)td> </thtr> <tr> <td width=400px>Tax Type</td> <td><textarea rows=1 cols=25 name=ss_BillingPostalCode readonlytaxtype>@bilzip@taxtype</textarea></td> </tr> <!--@end--tr> <td width=400px>Total</td> <td><textarea rows=1 cols=25 name=total>total</textarea></Appointment Confirmationtd> </tr> <th colspantr> <td width=400px>Tax Amount</td> <td><textarea rows="6" align1 cols="left" class25 name="titleText001"taxamt>taxamt</textarea>Appointment Confirmation</thtd> </tr> <tr> <th aligntd width="left"400px> Fax confirmation of appointmentGross Total</thtd> <thtd><textarea rows=1 cols=25 name=ss_Faxconfirmationofappointment readonlygrossamt>@faxconf.combovalue@grossamt</textarea></thtd> </tr> <tr> <thtd width=400px> Reference #</thtd> <th aligntd><textarea rows="left"1 cols=25 name=reference>reference</textarea></td> </tr> <tr> <td width=400px> Phone Confirmation#</td> <td><textarea rows=1 cols=25 name=confirmationnum>#12345-eee</textarea></td> </tr> <tr> <td width=400px>Provider Name</td> <td><textarea rows=1 cols=25 name=provider>provider</textarea></td> </thtr> <thtr> <td width=400px>Provider Emailr</td> <td><textarea rows=1 cols=25 name=ss_Phoneconfirmationofappointment readonlyprovideremail>@phoneconf.combovalue@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"></td> </tabletr> </divtable>

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[[Category:Universal Tracking ApplicationIntegration]][[Category:IntegrationExternal Services]]