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Add New Screen

The Add New screen allows you to enter a new listing into your personal Health Insurance record. There are several input fields available for you to record information about this entry. The available fields are described below. Some of these fields are required and some are optional. The required fields are indicated by an asterisk symbol (*). You must click the Save button for your entry to be recorded. You also have the option to "Save and Add Another," which will save your entry and open another Add New screen. After you click "Save" or "Cancel" you will be taken back to the Summary screen. The "Reset" button will return the fields to their original state (blank). If for some reason the system is not able to process your entry, the page will refresh with a message explaining what must be done to proceed.

Using this Page

Health Insurance Company (Required) - Enter the name of your health insurance company in this field. This name will be used to identify this record in the Summary screen. You may enter up to 50 characters.

ID Number (Required) - Enter the health insurance policy number here. You may enter up to 30 characters.

First Name of Insured (Required) - Enter the first name of the person on the health insurance policy. You may enter up to 50 characters.

Last Name of Insured (Required) - Enter the last name of the person on the health insurance policy. You may enter up to 50 characters.

Start Date (Required) - Enter the date the policy was started. Select a date by clicking on the calendar icon. The calendar icon will open a pop-up window with a clickable calendar. By clicking a date in the calendar, the date field will be automatically set and you may continue filling out the form.

End Date - Enter the date the coverage ended. Select a date by clicking on the calendar icon. The calendar icon will open a pop-up window with a clickable calendar. By clicking a date in the calendar, the date field will be automatically set and you may continue filling out the form.

Group Number - Enter the group policy number. You may enter up to 30 characters.

Pre-Approval Number - Enter the phone number for the pre-approval services of the health insurance company. You may enter up to 20 characters.

Health Insurance Company Phone Number - Enter the phone number of the health insurance company. You may enter up to 20 characters.

Comments - This is where you can enter any additional thoughts you had about this particular health insurance record. You may enter up to 255 characters.

Save or Save and Add Another - You must click one of these buttons to save the entry.