TruForm Classic: Medims Integration

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Instructions below ONLY apply to TruForm on MyPBHS.

In this section we will go over the following:

TruForm Integration Fields

This document includes ALL fields that integrate between TruForm and Medims. If your custom form is setup correctly, items listed below will populate within your software.  Note, if you have additional fields on your form that are NOT listed below, you can manually enter them into your patient's account once integration is completed!

If you use our standard form below, the sections listed below are already integrated!

PATIENT INFORMATION:

  • Title
  • First Name
  • Last name
  • Middle Initial
  • Nickname
  • Suffix
  • Gender
  • DOB
  • SSN
  • Work Phone
  • Work Ext
  • Home Phone
  • Cell Phone
  • Email Address
  • Address
  • Address 2
  • City
  • State or Province 
  • Zip or Postal Code
  • Drivers License
  • Marital Status
  • Employment Status
  • Employer Name
  • Employer Address
  • City, State Zipcode
  • School Status
  • School Name
  • School Address
  • School Address 2
  • City
  • State or Province 
  • Zip or Postal Code
  • School Phone

REFERRAL INFORMATION:

  • Title (Mr., Mrs., Miss., Dr.)
  • First Name
  • Last Name
  • Middle Initial
  • Address
  • Address 2
  • City
  • State or Province
  • Zip or Postal Code
  • Work Phone

PRIMARY DENTAL & MEDICAL 
INSURANCE INFORMATION:

  • Insured First Name
  • Insured Last Name
  • Insured Middle Initial
  • Insured Title
  • Insured Gender
  • Insured SSN
  • Insured DOB
  • Insured Address
  • Insured Address 2
  • Insured City
  • Insured State or Province 
  • Insured Zip or Postal Code
  • Insured Home Phone
  • Insured Work Phone
  • Insured Work Ext.
  • Insurance Company Name
  • Insurance Address
  • Insurance Address 2
  • Insurance City
  • Insurance State or Province 
  • Insurance Zip or Postal Code
  • Insurance Phone
  • Insurance Ext
  • Insured Group Name
  • Insured Group Number
  • Insured Insurance ID
  • Employment Status
  • Insured Employer Name
  • Insured Relationship
  • Insured Employment Status
  • Insured Employer Name
  • Insured Employer Address
  • Insured Employer Address 2
  • Insured Employer City
  • Insured Employer State or Province 
  • Insured Employer Zip or Postal Code
  • Insured Employer Phone
  • Insured School
  • Insured School Address
  • Insured School Address 2
  • Insured School City
  • Insured School State or Province 
  • Insured School Zip or Postal Code
  • Insured School Phone
  • Insured School Ext.

Software Integration Re-cap:

This software integration integrates a set amount of fields for:

  • Patient Demographic fields
  • Primary Medical & Dental Insurance Fields 

Medims Software Support Information:

You can contact Medims Support Below (for existing clients only):

Phone: 800-498-8324
Email: support@medims.com
Support Page: [Click Here]

 

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