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Expanded Reimbursement of Hospitalization Expenses (ERHE) of PNP Personnel

Expanded Reimbursement of Hospitalization Expenses (ERHE) of PNP Personnel

The Reimbursement of Hospitalization Expenses (RHE) scheme for PNP personnel in the active service is an adjunct health care delivery structure to the Health Service logistics support system and the benefits derived thereof is construed as an additional privilege and not a right which therefore has to be exercised in the best lights and always subject to the availability of funds. 

The maximum reimbursable hospital expenses is six months reckoned from the time it is incurred regardless of whether or not the personnel concerned has been separated from the service or whether the injury or sickness has been cured or not, while the maximum number of days a personnel may be confined is 365 days after which he/she shall be thoroughly evaluated for fitness to remain in the active service. 

 

NOTE: ERHE is a PRIVILEGE, NOT a right and is always subject to the availability of funds.

SCOPE/COVERAGE

 

Benefits derived hereof shall include the hospitalization expenses of:

a.) All active PNP personnel confined in PNP General Hospital and/or Medical Facilities, or PNP accredited government and/or private hospitals due to injury/illness;

b.) All active PNP personnel admitted as emergency case in private and/or government hospitals under the following circumstances:

  ü  For emergency admissions in other hospitals, provided the injury is service connected and provided further that the patient is immediately evacuated to PNP General Hospital/ PNP medical facility as soon as the condition permits.

 

   ü  For emergency admission in other hospitals where there is a PNP Medical Facility ( to include PNP General Hospital) provided that the management of the patient is not within the capability of the PNP medical facility and provided further that the patient is immediately evacuated to the PNP medical facility as soon as the condition permits.

 

ü  All active PNP personnel confined/admitted for non-urgent conditions which are not manageable at PNP General Hospital/PNP medical facility, provided that the Chief PNP General Hospital/ PNP medical facility gives proper authorization

a.) Entitlement

1) For Police Operations Battle Casualties, reimbursement is FULL.

 

2) For Non-Battle Casualties:

   ü  Non-urgent Medical Cases – maximum of Php60,000.00

   ü  Surgical Cases – maximum of Php100,000.00

      ü  Intensive and Catastrophic Cases – maximum of Php350,000.00

PNP reimbursement
Photo: PNP

b.) Where to file RHE claims:

1) For National Headquarters and National Support Unit—RHE Section, MSD Office, HS

2) For Police Regional Offices and NSUs with Regional Offices—Regional Health Service (RHS)

 

c.) When to file RHE claims.

Claims may be filed either during the period of confinement or upon discharge from confinement but in no case to exceed 60 days there from.

HOSPITAL BENEFITS (AUTHORIZED RATES)

 

Room and Board                   –           1,500/day

Professional Fees              

                        Medical          –           350/day (Ordinary)

                                               –           750/day (Intensive)

 

                        Surgical          –           10,000 (Minor)

                                               –           10K to 20K (Intermediate)

                                               –           20-60k (Major)

Anesthesiologist                     –           30% of Surgeon Fee

Medicines                               –           35,000 (max)

Medical Supplies                    –           35,000 (max)

Ambulance Fee                      –           1,000 (max)

Laboratory                                         30,000 (max)

Photo: PNP

TABLE OF CONTENTS

Requirements for ERHE Claims

 

      A.   Unit Endorsement (From CD/PD/C,NSU)          

      B.   Processed Disbursement Voucher/LBP ATM Card

      C.   Computation Sheet            

      D.   Hospital Billing Statement

      E.   Official Receipts                  

      F.    Original Medical Certificate                       

      G.   Clinical/Narrative Summary

      H.   Personal Letter Request

       I.    Sick Call Slip/Confinement Order           

      J.    Sick Leave Order    

      K.   Investigation Report                                   

      L.    PNP I.D. (Photocopy, Authenticated by Admin)

      M.   Service Record                    

      N.   Duty Status                          

      O.   Certificate of Non-payment

RHE Application Form PNP
RHE Application Form

In case of Vehicular Accident

          Traffic Accident Report

          OR, CR & Driver’s License (Authenticated by Issuing LTO)  (TAB P)

 

In case of Death

          Marriage Contract/Death Certificate

          Letter Request for ID of Legal Beneficiary

          Certificate of Legal Beneficiary from PRBS (TAB Q)

 

Note: 

1.    All requirements must be in two (2) folders (Original and Machine Copy)

2. Include in the IR whether the sickness/illness was acquired in the Performance of Duty or not.

3.    Submit all requirements with 45 days (Starting from date of Discharge from Hospital) Late folders will not be accepted base on ERHE/RHE Guidelines.

4.    Indicate your personal contact number.

5.     Please attach One (1) 1×1 and 2×2 PNP ID picture.

Flow Chart of the ERHE

GROUNDS FOR DENIAL OF CLAIMS

a) By intoxication or drunkenness or various immoral habit or intemperate use of regulated or prohibited drugs.

b) If the illness is due to abuse of lifestyle

c) In case of injury caused by a third party

Source: PNP MC No. 2021-040

             PNP MC No. 2011-011