truForm: Software Integration

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Instructions below ONLY apply to truForm.

 The TruForm integration requires no additional charge from PBHS, and can be setup at anytime with your PBHS TruForm order. Please contact PBHS Support further if you are ready to start this process.

Once the integration settings are added to your form(s) and truForm account, you will need to set your own integration credentials through your new truForm account's profile settings and provide this information to your software representative directly (PBHS does not have access to this information). Instructions on setting your integration credentials through the portal can be found HERE.

*Please note, you will need to contact your software provider to obtain more information about the pricing for their TruForm bridge, as there may be additional fees.


Software Integration Details

Medims

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:

  • Prefix
  • First Name
  • Last name
  • Middle Initial
  • Suffix
  • Gender
  • Date of Birth
  • Social Security Number
  • Work Phone
  • Home Phone
  • Cell Phone
  • Email Address
  • Address Street Name
  • Address Apt
  • City
  • State or Province 
  • Zip or Postal Code
  • Drivers License
  • Marital Status
  • Employment Status
  • Employer Name
  • Employer Address
  • City, State Zipcode
  • Dentist First Name
  • Dentist Last Name
  • Doctor First Name
  • Doctor Last Name
  • Referred by First Name
  • Referred by Last Name

SCHOOL AND INSURANCE
INFORMATION:

  • School Status
  • School Name
  • School Address
  • City
  • State or Province 
  • Zip or Postal Code
  • School Phone
  • Marital Status
  • Employed Status

 

EMERGENCY CONTACT
INFORMATION:

  • Emergency Full Name
  • Phone Home
  • Relation 

RESPONSIBLE PARTY
INFORMATION:
 

  • Relationship Description
  • First Name
  • Last Name
  • Social Security Number
  • Date of Birth
  • Email
  • Drivers License
  • Address Street Name
  • Address Street Name 2
  • City
  • State or Province
  • Zip or Postal Code
  • Employer Name
  • Phone Home
  • Phone Work
  • Phone Cell

PRIMARY & SECONDARY DENTAL / 
MEDICAL INSURANCE 
INFORMATION:

  • Employer Name
  • Employer Address Street Name
  • Employer City
  • Employer State or Province 
  • Employer Zip or Postal Code
  • Employer Work Phone
  • Employer Plan Name
  • Insurance Company Name
  • Insurance Company ID
  • Insurance Company Address Street Name
  • Insurance Company City
  • Insurance Company State or Province
  • Insurance Company Zip or Postal Code
  • Insurance Company Phone
  • Insurance Company Group Name
  • Insurance Company Group Number
  • Insured First Name
  • Insured Last Name
  • Insured Relation to Patient
  • Insured Birthdate
  • Insured Gender
  • Insured Social Security Number
  • Insured Home Phone
  • Insured Address Street Name
  • Insured City
  • Insured State or Province
  • Insured Zip or Postal

Software Integration Re-cap:

This software integration integrates a set amount of fields for:

  • Patient Demographic fields
  • Primary/Secondary Medical & Dental Insurance Fields 

 

Henry Schein

Integration with our mysecurepractice.com truForm v6 system is available for v15.0 and above of:

  • OMSvision
  • PERIOvision
  • ENDOvision
  • Dentalvision Group Practice Edition
  • Dentalvision Enterprise

Please note, v.15.0 and up will only work with this truForm integration if this version was installed 09/23/2016 and after. 

Click here to check your version and date
 

This includes ALL fields that integrate between TruForm v6 and Henry Schein v15.0+. If your custom form is setup correctly, items below will populate within your software. Note, if you have additional fields that are NOT listed below, you can manual enter them into your patients account once integration is completed!

If you use one of our standard forms below, the sections listed below are already integrated!

PATIENT INFORMATION:

Prefix
First Name
Middle Initial
Last Name
Gender (M/F)
Martial Description
Date of Birth
Age
Social Security Number
Home Phone
Cell Phone
Email


*IF YOU ARE USING A CUSTOM FORM: Patient Address/ City/ State must be split out into its own fields in order to integrate correctly.


Address Street Name
Apt
City
State or Province
Zip or Postal Code

Patient former patient?
Family member former patient?


*IF YOU ARE USING A CUSTOM FORM: Dentist/Doctor/Referred By/Nearest Relative Names on the form must be split out into first name last name in order to integrate correctly.


Dentist First Name
Dentist Last Name

Orthodontist First Name
Orthodontist Last Name

Medical Doctor First Name
Medical Doctor Last Name

Referred By First Name
Referred By Last Name

Driver’s License

Nearest Relative First Name
Nearest Relative Last Name
Nearest Relative Phone

Employer Name
Work Phone

Work Ext.


Payment Method

Emergency Full Name
Phone
Relation

SPOUSE OR OTHER GUARANTOR INFORMATION:
First Name
Last Name
Relationship to Patient
Relationship Description
Date of Birth
Social Security Number
Address Street
Apt
City
State or Province
Zip Code or Postal Code
Home Phone
Employer Name
Work Phone

RESPONSIBLE PARTY INFORMATION:


*IF YOU ARE USING A CUSTOM FORM: Responsible Name on the form must be split out into first name last name in order to integrate correctly.


First Name
Last Name
Suffix
Relationship to Patient
Social Security Number
Date of Birth
Age

Address Street Name
City
State or Province
Zip or Postal Code
Employer Name
Phone Home
Phone Other
Email
Driver's License
Employer Name
Phone Work


SCHOOL AND INSURANCE INFORMATION:


*IF YOU ARE USING A CUSTOM FORM: School Name/ Address/ City/ State must be split out into its own fields in order to integrate correctly.


School Status (Full, Part, Not)
School Name
School Address Street Name
School City
School State or Province
School Zip or Postal Code

Employer Status(Full, Part, Not)
PPO or HMO?

PRIMARY & SECONDARY
DENTAL & MEDICAL
INSURANCE INFORMATION:

*IF YOU ARE USING A CUSTOM FORM: Each insurance type (primary medical, primary dental, secondary medical, secondary dental must be separated into its own area for each question below in order to integrate correctly.


*IF YOU ARE USING A CUSTOM FORM: All Address/ City/ State must be split out into its own fields in order to integrate correctly.


*IF YOU ARE USING A CUSTOM FORM: Insured Name on the form must be split out into first name last name in order to integrate correctly.


Insured Relation to Patient
Insured First Name
Insured Last Name
Insured Gender (M/F)
Insured Date of Birth
Insured Social Security Number
Insured Home Phone
Insured Home Address Street
Insured City
Insured State or Province
Insured Zip Code or Postal Code
Phone


Insured Employer Name
Insured Employer Address
Insured Employer City
Insured Employer State or Province
Insured Employer Zip or Postal
Insured Employer Phone Number


Insured Policy Group Name
Insured Policy Group Number
Insured Policy ID
Insured Policy Plan
Insured Insurance Company Name
Insured Insurance Address Street
Insured Insurance City
Insured Insurance State or Province
Insured Insurance Zip/ Postal Code
Insured Insurance Phone Number

HEALTH HISTORY:

Reason for today's office visit
Weight

Height
1. Are you in good health
2. Have there been any changes in your general health in the past year
3. Are you under the care of a physician / If so, for what are you being treated? / Date of last visit
4. Have you had any illness, operation or been hospitalized in the past five years / If so, describe
5. Do you have unhealed / recurrent injuries or inflamed areas, growths or sore spots in or around your mouth / If so, describe where
6. Do you have a prosthetic joint / implant / If so, describe where
7. Have you had a heart valve replacement or vascular graft
DOES NOT INTEGRATE: 8. Have you ever had general anesthesia?
9. Have you, or a family member, had any unusual or serious reactions to general anesthesia?
10. Has a physician or previous dentist recommended that you take antibiotics prior to your dental treatment?


*IF YOU ARE USING A CUSTOM FORM:
If you have a group of problems/issues in one question- they will not integrate. They must be laid out similar to the format given below.

Some items we group together, will come over as one item, see below:


11. Rheumatic fever?
12. Damaged heart valves / mitral valve prolapse?
13. Heart murmur?
14. High blood pressure?
15. Low blood pressure?
16. Chest pain / angina?
(Comes over as angina)
17. Heart attack(s)?
18. Irregular heart beat?
19. Cardiac pacemaker?
20. Heart surgery?
21. Pneumonia, bronchitis, chronic cough?

(Comes over as bronchitis/chronic cough)
22. Asthma?
23. Hay fever / sinus problems?
24. Snoring
25. Sleep apnea / CPAP?
26. Difficult breathing / other lung trouble?

(Comes over as other lung trouble)
27. Tuberculosis?
28. Emphysema?
29. Do you smoke? / If so, number of packs per day
30. Do you use chewing tobacco?
31. Blood transfusion?
32. Blood disorder such as anemia?

(Comes over as anemia)
33. Bruise easily?
34. Bleeding tendency / abnormal bleed?

(Comes over as bleeding tendency)
35. Hepatitis, jaundice, or liver disease?
36. Infectious mononucleosis?
36. Gallbladder trouble?
38. Fainting spells?
39. Convulsions / epilepsy?
40. Stroke?
41. Thyroid trouble?
42. Diabetes?
43. Low blood sugar?
44. Kidney trouble?
45. High cholesterol?
46. Are you on dialysis?
47. Swollen ankles / arthritis / joint disease?

(Comes over as arthritis)
48. Osteoporosis / osteopenia?
49. Osteonecrosis?
50. Stomach ulcers / acid reflux?

(Comes over as stomach ulcers)
51. Contagious diseases?
52. Sexually transmitted diseases?
53. Problems with immune system? Possibly from medication / surgery, etc.
54. Delay in healing?
55. A tumor or growth?

56. Cancer / radiation therapy / chemotherapy?
(Comes over as xray or chemo)
57. Chronic fatigue / night sweats?
58. Are you on a diet?

59. A history of alcohol abuse?
60. A history of drug abuse?
61. Contact lenses?
62. Eye disease / glaucoma?
63. Mental health problems / anxiety / depression?

(Comes over as mental health problems)
64. A removable dental appliance?
65. Pain or clicking of jaws when eating?


WOMEN ONLY:

66. Is there a possibility of pregnancy?
67. Expected delivery date?
68. Are you nursing?
69. Are you taking birth control pills?


MEDICATION:

70. Any kind of medication, drug, pills?
71. Blood thinners (Coumadin, Plavix, Aspirin, Vitamin E, Ginko biloba, Aggrenox, Pradaxa, Fish oil)?
72. Have you ever taken diet pills?
73. Any natural product, herbal supplement or homeopathic remedy?
74. Are you taking, or have you ever taken, bone density meds. or bisphosphonates such as Fosamax, Boniva, Actonel, IV– Zometa, Aredia, or Reclast in the past 12 years?
75. Tranquilizers, sleeping pills, anti-depressants, and/or narcotics on a regular basis? If so, please list:
76. Please list any medications you are currently taking:

**Maximum of 20 medications, dosage and frequency**


ALLERGIES:

77. Local anesthetic (numbing meds.)?
78. Penicillin?
79. Other antibiotics?
80. Sulfa drugs?
81. Sodium pentothal / Valium /other tranquilizers?
82. Aspirin?
83. Amoxicillin?
84. Codeine or other narcotics?
85. Latex?
86. Soy?
87. Eggs / yolk?
88. Sulfites?
89. Do you have any known allergies?
90. Please list any allergies other than drug allergies:
91. Please list any other medication or antibiotic you are allergic to:
**Maximum of 10 allergies to medications/antibiotics**


FAMILY HISTORY:

Family History of Cancer
Family History of Diabetes
Family History of Heart Disease
Family History of Anesthetic Problems


INJURY INFORMATION:

Is visit related to an accident?
Type of accident- auto/work/other
Date of injury
Insurance Company Handling Claim
Claim Number
Attorney or Adjustor
Attorney Phone


HH PERSONAL INFORMATION:

If you are having surgery today, have you had anything to eat or drink in the last 6 (six) hours?
Who is driving you home?

Is there any condition concerning your health that the Doctor should be told about?
If Yes, why?
Do you wish to speak to the Dr. privately about anything?

Software Integration Re-cap:

This software integration integrates a set amount of fields for:

  • Patient Demographic Fields (reviewed above)
  • Responsible Party Fields (reviewed above)
  • Primary and Secondary Dental/Medical Insurance Fields (reviewed above)
  • Health History Fields (reviewed above)
  • Medication Fields (reviewed above)
  • Allergies Fields (reviewed above)
  • Integration of the patients submitted form within the patient's account

 

Henry Schein - Check your version and install date

  1. Within your Henry Schein software, select the "Help" drop down menu
  2. Select "About" and a small window will pop up
  3. You will see the version of the software you are on, and the date it was installed at the bottom of this window (centered)- see below, highlighted in yellow
  4. You must have the version 15.0 and the install must be 9/23/2016 or after for integration to work correctly.  
    PBHS.png

 

Henry Schein - Software Version Differences

  • "Use new API“ would need to be checked within the HS software
  • MySecurePractice.com TruForm can only be used with HS software v.15.0 and up (and this software version has to be installed 9/23/16 and after for integration to work).

(most clients will jump from 15.0 to 15.1, skipping 15.0 PST)

Software Version

DV v15.0
installed 9/23/16 or after

DV v15.0 PST
installed 9/23/16 or after

DV v15.1 &
v15.1 PST 
installed 9/23/16
or after

DV v15.2
installed 9/23/16
or after

Platform Used 

  • Same as DV v15.0
  • Same as DV v15.0
  • Same as DV v15.0

TF Integration

  • Same as DV v15.0
  • Same as DV v15.0
  • Same as DV v15.0

Additional Features
    

   

   

  

    

  

  • Integration for new patients only
  • Multi-office:  If you share one Henry Schein software database, you can only have one truForm login for all offices to share
  • Allergies displayed
  • Medical History Surveys created in EHR for new (pre-reg) patient when those patients are registered
  • Same as DV v15.0,
      
    Plus:
      
  • Integration for new and existing patients (preference setting in DV)
  • Download Multiple Forms for one patient
  • Multi-office:  If you share one HS database, you can now have a truForm login for each office. PBHS will need your Henry Schein Location ID and fees will apply for mutli-office setup.
  • Everything in 15.0 and 15.0 PST

 

  • Everything in 15.0 and 15.0 PST

 

 Henry Schein - Identifying your Location ID

  1. Within your Henry Schein Software, select the "File" drop down option
  2. Select "Locations"
    hs1.png
  3. Please let us know the office name, and associated "#" to the LEFT of the "Location Name"
    hs2.png

If requested, please send this information directly to support@pbhs.com OR reply back to the email request from support.  

 

 

EDDSON

This document includes ALL fields that integrate between TruForm and EDDSON. If your custom form is set up 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:

  • First Name
  • Last name
  • Middle Initial
  • Nickname
  • Gender
  • Date of Birth
  • Social Security Number
  • Email Address
  • Home Phone
  • Cell Phone
  • Address Street Name
  • Address Apt
  • City
  • State or Province 
  • Zip or Postal Code

Software Integration Re-cap:

This software integration integrates a set amount of fields for:

  • Patient Demographic fields

Integration Credentials

*Currently only available for Medims, Cerner, EDDSON, and Henry Schein practice management softwares*

Setting TruForm Integration Username and Password

Before you start this process, please check in with PBHS Support to ensure your portal login has access to TruForm.   Once confirmed, please follow the below instructions:

  1. Login to https://mysecurepractice.com/ using your truForm doctor account.
  2. Select the "Access Forms" icon on your dashboard

    dashboard.png

  3. In your upper right hand corner select your name with the avatar icon next to it
  4. Select the "Profile" drop down option as seen below:

    Update_Profile_No_Longer_On_First_Dashboard.png

  5. On the “Account Profile” tab, scroll down until you see the “Practice Software Integration for Truform and Collaborator” section:




  6. Click the “Generate New Integration Credentials” button.
  7. This will automatically fill out the “Integration Username” field with a username based on your email address, and generate an “Integration Password”.
    • Please make note of this generated username/password from this page, once saved you will no longer see this for security purposes.
    • PBHS recommends you physically copy (highlight each with your cursor and COPY) both the username/password from this screen onto a word document or a notepad to ensure you have the correct letters/special characters or numbers used.  Once ready, you can then copy the noted username/password from the word document or notepad, and paste each one into your software.  
    • MEDIMS CLIENTS PLEASE NOTE: Your software cannot use an integration password generated with a double quotation, please regenerate your credentials if they are originally generated with a double quotation.
  8. At the top of the page, select “Save Profile” to finalize these changes:


You will need to provide this information (generated user/pass) to your software company.  They will need this information to input within your software and show your office how to use integration through your software.  Please contact your software support or representative for further instructions.

 

 

 

 

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