how-to-apply-for-reimbursement-of-hospitalization-expenses-rhe-claims

How to Apply for PNP Reimbursement of Hospitalization Expenses (RHE)

The Reimbursement of Hospitalization Expenses (RHE) is a program designed to provide financial assistance to active members of the Philippine National Police (PNP) who incur medical expenses due to confinement, surgery, or emergency treatment. It was specifically designed to supplement the free medical service offered in PNP General Hospital (PNPGH) and PNP medical facilities in case it cannot provide the treatment that they need. 

If you or your family member in the PNP need hospitalization assistance, financial relief is available through the RHE program. This guide explains what the RHE program is, its purpose, benefits, coverage, requirements, and the step-by-step process on how to apply, so you can better understand how to avail of this medical assistance.

Why RHE Matters 

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Photo credit: PNP

Hospitalization expenses can quickly drain a family’s savings. Through the RHE program, PNP personnel can receive much-needed medical assistance, ensuring that they and their dependents are protected from financial strain during emergencies.

This benefit is more than just a reimbursement—it is a recognition of the sacrifices of police officers and an important support system that allows them to focus on recovery and service.

Purpose and Goals 

In fact, the program was specifically established to:

  • Support PNP personnel injured in the line of duty, including police operations and battle casualties.
  • Provide hospitalization reimbursement for emergency and non-emergency medical cases not manageable in PNP hospitals.
  • Extend medical assistance to officers suffering from service-connected sickness or injuries.
  • Reduce the financial strain on PNP dependents by covering a significant portion of medical expenses.

Ultimately, the program aims to safeguard the well-being of police officers so they can continue fulfilling their duties without the burden of overwhelming hospital expenses.

Benefits and Coverage

This program was designed to cover a wide range of hospitalization expenses, though each one is subject to prescribed ceilings:

  • Room and Board: up to ₱1,500 per day
  • Intensive Care Unit (ICU): prevailing hospital rates until crisis is over
  • Professional Fees
    • Ordinary medical case: ₱350/day
    • Intensive or catastrophic case: ₱750/day
    • Surgical case:
      • Minor: up to ₱10,000
      • Intermediate: ₱10,000–₱20,000
      • Major: ₱20,000–₱60,000
    • Anesthesiologist: 30% of the surgeon’s fee
  • Medicines and Medical Supplies: up to ₱35,000 each
  • Ambulance Fee: up to ₱1,000
  • Laboratory Work-ups: up to ₱30,000

Maximum Reimbursable Amounts

  • Police Operations (Battle Casualty): Full reimbursement (subject to funds)
  • Ordinary Medical Case: Up to ₱60,000
  • Surgical Case: Up to ₱100,000
  • Catastrophic/Intensive Case: Up to ₱350,000

Pregnancy Benefits for Female PNP Personnel

  • Normal Delivery: up to ₱10,000
  • Caesarean Section: up to ₱20,000

The maximum reimbursable expenses cover a period of six (6) months from the time they are incurred. Meanwhile, PNP personnel who are incapacitated for 365 days due to illness or injury are evaluated for their fitness to remain in service.

Who Can Avail?

The program covers the following target beneficiaries:

  • All active PNP personnel confined in PNP General Hospital, PNP medical facilities, or accredited hospitals.
  • Active members admitted as emergency cases in private or government hospitals under specific conditions:
    • If no PNP hospital is available nearby.
    • If the case is service-connected.
    • If treatment is not within the capacity of a PNP facility.
  • PNP personnel confined for non-urgent conditions that cannot be managed by PNPGH, provided authorization is given.
  • Female PNP personnel are entitled to reimbursement packages for pregnancy-related confinement (Normal Delivery or Caesarean Section).
  • PNP personnel confined in government hospitals for mental health issues.

Requirements for Application

To apply, you will need to prepare and present the following requirements:

Documents to be Prepared by the Claimant

  • Accomplished RHE Application Form
  • Clinical Abstract or Discharge Summary (with physician’s name, license number, and signature)
  • Operative Technique and Histopathology Report (for surgical cases)
  • Statement of Account from hospital
  • Official Receipts (original)
  • Photocopy of PNP ID
  • Photocopy of Landbank ATM with account number
  • Investigation Report

Documents from Unit/Station

  • Sick Leave Order
  • Verification from PAIS
  • Certificate of Non-payment from Finance Service
  • Traffic Accident Report (for vehicular accidents)
  • Unit Endorsement: from the personnel’s unit.
  • Processed Payroll/Disbursement Voucher (DV): from the unit.
  • Approved Report Adjudication Board: from ITMS/FS/RFSO/FSO.

Additional Requirements in Case of Death

  • Certificate of Declared Legal Beneficiaries (PRBS)
  • Valid ID of beneficiary
  • Death Certificate
  • Marriage Certificate and/or children’s Birth Certificates

How to Apply 

This section details both the hospitalization and RHE claims application procedures that you can follow:

For Hospitalization

For Non-Emergency Cases

Step 1. Secure a Letter of Authorization (LOA) from PNP Health Service Facility if PNPGH cannot manage the condition.

Step 2. Present the LOA and PNP ID to an accredited hospital.

Step 3. Upon discharge, collect and sign all necessary documents for reimbursement.

For Emergency Cases

Step 1. Present PNP ID to the hospital.

Step 2. Inform PNP Health Service within 24 hours and secure LOA.

Step 3. Once stable, transfer to PNPGH or a PNP Medical Facility.

Step 4. Submit documents for reimbursement.

For RHE Claims Application

Step 1. Filing of RHE Application

  • The personnel (or claimant) must file their RHE application within 90 days from the date of hospital discharge.

Step 2. Initial Checking by RHE Secretariat, HS

  • The RHE Secretariat reviews the documents to ensure they are complete.
    • If complete: The claim application will be sent to the Adjudication Board.
    • If incomplete: The claimant is given 30 days to comply.

Step 3. 30-Day Compliance Period

  • The applicant submits the missing documents within the 30-day window.
    • If completed within 30 days: moves forward to the Adjudication Board.
    • If still incomplete: the Adjudication Board decides whether to extend the grace period or deny the claim.

Step 4. Adjudication Board (every 1st Friday)

  • The Adjudication Board evaluates the claim.
  • If the documents are complete and valid, it is forwarded to the Approving Authority.
  • If not, the claim is denied.

Step 5. Approval by the Approving Authority

  • The Approving Authority signs the claim within 3–5 days from receipt.
    • If approved: The application goes back to the RHE Secretariat.
    • If not approved: the RHE Secretariat endorses the case to TDPRM/RPRMD who will inform the personnel of disapproval.

Step 6. Preparation of Disbursement Voucher

  • For approved claims, the RHE Secretariat prepares the disbursement voucher within 3–5 days.

Step 7. Processing by BFO, DPRM

  • The claim is forwarded to the Budget and Finance Office, DPRM, which processes the disbursement voucher for another 3–5 days.

Step 8. Processing by Fiscal Division, DC

  • The Fiscal Division, DC processes the fund allocation for 5–15 days.

Step 9. Release of Payment

  • Depending on the type of claim:
    • PROs/SAP Claims → Released through RFSO → Landbank → PNP Personnel.
    • NHQ Claims → Released through 14th FSO, FS → Landbank → PNP Personnel.

Note: For RHE of PNP Personnel (for those processed at the National Headquarters (NHQ), and for claims over Php60,000), the procedure is handled by the Budget and Fiscal Office (BFO, DPRM).

Fees and Processing Timeline

Take note of the following fees and timelines:

  • The maximum reimbursable amount depends on the case type (₱60,000–₱350,000).
  • PhilHealth and HMO deductions are applied before reimbursement.
  • Processing typically involves hospital SOA submission, Adjudication Board verification, and Comptrollership approval.
  • Approved claims are disbursed once funding is available, usually within weeks after approval depending on budget allocation.

Where to Get the Application Form

The application form and requirements checklist for Reimbursement of Hospitalization Expenses (RHE) can be found in the official PNP Memorandum Circular (MC) 2021-040:

  • Annex A: Checklist of Requirements to guide claimants on what documents to prepare
  • Annex B: Official RHE Application Form
  • Annex C: Computation Sheet for the allowable reimbursement amount

You can request a copy of the forms from your PNP Finance Service (FS), Health Service (HS), or Unit Admin Office. Some Regional Personnel & Records Management (RPRMD) offices also keep copies for distribution to claimants. Or, you can check online for a copy of the NAPOLCOM MC 2021-040 (with all the annexes attached). You may also directly download the forms from the links above.

Grounds for Denial of Claims

Take note that submitting an application does not always mean automatic approval. There are certain conditions that may disqualify a claim. These conditions include:

  • Failure to submit documents within the prescribed period.
  • Hospitalization due to uncomplicated pregnancy and normal delivery (except covered packages).
  • Refusal to transfer to PNPGH when medically feasible.
  • Injuries or sickness caused by:
    • Drunkenness, drug use, or immoral acts
    • Willful self-harm or misconduct
    • Unauthorized absence (AWOL)
    • Lifestyle-related illnesses linked to negligence (e.g., uncontrolled diabetes, liver disease from alcoholism, STDs from risky behavior)
  • Submission of falsified, tampered, or non-medical receipts.
  • Claims exceeding prescribed ceilings or not covered under diagnosis.
  • Injuries caused by traffic violations (e.g., DUI, no license, reckless driving).
  • Failure to avail of PhilHealth or HMO benefits before claiming from PNP.

Important Reminders

To ensure a smooth and successful application for RHE claims, applicants must keep these things in mind:

  • Filing deadline: within 90 days of hospital discharge.
  • Missing documents: 30 days grace period to comply.
  • Processing involves multiple layers: Secretariat → Adjudication → Approval → Budget/Fiscal.
  • Average processing time: roughly 20–40 working days after approval, depending on completeness and speed of fund release.
  • Final reimbursement: credited via Landbank to PNP personnel.

Contact Information

For inquiries or other concerns regarding the RHE application, you may reach out to: 

National Police Commission (NAPOLCOM) NHQ

  • Office Address: DILG-NAPOLCOM Center, NAPOLCOM Building, EDSA cor Quezon Avenue, West Triangle, Quezon City
  • Telephone: 8897-5021

PNP Welfare Benefits Section (Financial Services)

  • Catherine C. Fronda, Acting Division Chief, Budget & Fiscal Division
    • Tel. No.: 8897-0845
    • Email Address: bfd.fs@napolcom.gov.ph
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