All Individually Paying Members (IPMs) enrolled by organized groups through the KASAPI Program and their dependents are required to submit the following documents in availing of National Health Insurance Program (NHIP) benefits:

• Duly accomplished PhilHealth Claim Form 1
• Clear copy of Certificate of Premium Payment issued by PhilHealth to individual KaSAPI members showing payment of at least three (3) monthly contributions within six (6) months prior to confinement or one full quarter payment within six months prior to the quarter of availment. Attached is a sample Certificate of Premium Payment^* for KaSAPI member for your reference.
• Clear copy of Member Data Record (MDR)

In case the member has not yet secured his/her MDR or there is a discrepancy in the member/dependent ™s information provided in PhilHealth Claim Form 1 and the MDR such as different first/middle/last name or change of civil status, or the dependent is not yet reflected in the MDR, the member shall submit/attach to Claim Form 1 a clear copy of the appropriate supporting document/s as prescribed in PhilHealth Circular No. 26, series of 2006 re: œUpdated Summary of Documentary Requirements .

Please be guided accordingly.

Adopted: 06 Nov. 2007

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^* Text Available at Office of the National Administrative Register U.P. Law Complex, Diliman, Quezon City.