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
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)
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
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.
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. 2011-011