Gym Reimbursement Sample: Fill & Download for Free

Yes. It’s totally unethical for those gyms to sell memberships knowing full well that many members will not attend regularly after a few weeks but will continue to pay their regular membership fees, sometimes for years, simply because they’re thinking of getting back into shape (and never seem to make to effort to do so other than pay the fee).What those unethical gyms should do instead is as follows.They should require a new member to sign a contract with certain terms and conditions - of which a sampling follows;You agree that as s a member you are required to be in attendance at the gym [x number of times] per month.You agree that failure to meet your attendance requirements for two months in a row, or for three months of the year in total, will result in your membership from this gym being revoked and your membership fees being refunded back to you. You will or be allowed to rejoin the gym without proof of your belief in and commitment to being active and fit.(See following point for exclusions).You may be excused from your attendance obligations if you have proof of extenuating circumstances. For example, an illness for which a doctor’s note is sufficient proof. Or your trip itinerary proving you were away on vacation. Your spouse’s death certificate to prove you were attending her funeral. Etc.Persuant to clause #2, as a member in good standing of this gym, you agree that those delinquents who have had their memberships revoked and fees reimbursed will result in the fee burden being passed on to members in good standing in the form of fee surcharges or raised fees.You agree to accept these fee surcharges as a symbol of your commitment and belief in this gym and as someone who will continue to enjoy the life giving benefits of good health and wellbeing and in solidarity with your fellow gym members who also remain committed to this gym.In light of clause #4 above, you are strongly encouraged to watch for others who may be waning in their commitment to the gym and to step in and help them see the value of continued commitment and to influence them to keep up their attendance. Offering to pick them up and give them rides to the gym, for example.To help you in keeping others involved (see clause #5), the gym will provide on request a list of names of low attenders in danger of becoming lost to the gym.We appreciate that there will be those that choose to leave the gym no matter what you do. To mitigate the burden of fees on those who remain, you are encouraged to solicit new members on an active and continuous basis. The gym will provide training on how to do this either with your friends, family, and coworkers, or from strangers on a door to door basis.Those are some of the clauses I can think of off the top of my head to help the gyms behave in an ethical manner by not allowing members to do whatever they want by playing fast and loose with how they spend their money.

Original Question: Do the police in the US get benefits like the military?Today there is something like 18,000 law enforcement agencies, and perhaps a million peace officers of various flavors throughout the US, including full-time, part-time, reserve, auxiliary, Federal/State/local (county/city/township)/tribal/special jurisdiction (port authority/airport/harbor/railroad/etc.), corrections, fish and game, park rangers, special investigators, constables, bailiffs, military police, and more, as defined by each jurisdiction.[1][1][1][1]There is no “standard” set of benefits, like there is for the US armed forces.Some Agencies, especially at the Federal level, or State level like the California Highway Patrol, or in high-cost areas like San Francisco, LA, etc., have excellent pay, benefits, and retirement plans.Others…a moderate package of pay, benefits, and pension plans.And others again…not so much.As public safety agencies, all of them are subject to the whims of the budget process for their governmental patron, whether that is the Feds, a State, a tribal nation, a local entity, or a multi-role organization like railroad or harbor or port authority police.Often, but not always, those agencies with unions have better pay and benefits, although sometimes the unions themselves offer some of those benefits, rather than the Agency, so some of the better pay achieved by the unions is plowed right back into union dues and premiums for various benefits offered by their union rather than by the Agency. So it depends.A sampling of various “benefits” among US law enforcement agencies (hereafter “Agencies”) might include:[2][2][2][2]Paid wages/salaries (and possibly overtime).Accrual of paid time off (PTO) for vacation, sick leave, perhaps other special types of leave.Ability to contribute to some sort of typically pre-tax medical, dependent, or elder-care reimbursement plans.Toll-road, ferry, or other transportation stipend or reimbursement program.A very, very few public safety agencies offer some sort of “commissary-like” privilege, with what amounts to a private grocery store with subsidized low prices, or even discounts written into law or a contract with private businesses…but it might happen, especially when a union uses leverage to include such a discount in the bargaining agreement (or the union offers such a benefit to members…regardless of Agency).[3]Virtually all public safety agencies in the US have some sort of state-required Workmen’s Compensation laws and rules in place, to cover “on the job” injuries in the line of duty — in addition to whatever medical coverage is offered HMO’s, PPO’s, usually some choices from poor and cheap coverage up to gold standard coverage that costs a big chunk of the pay check. A severe enough injury/illness caused in the line of duty might result in a disability retirement under the state’s disability laws, or some version of a public safety disability pension, depending on how the specific state, Agency, union, etc., have it set up and the nature of the career-ending injury/illness.[4]Most Agencies (or the unions that represent the rank and file, often up to Sergeant-level) offer some sort of dental and vision benefit (at varying costs and levels of coverage).A certain amount of term life insurance (often about one year’s wages) is usually included as a standard benefit by the Agency, and most Agencies (or unions) will provide supplemental group insurance for the member and perhaps their family members at group rates, if the member wishes to purchase it.Most Agencies offer at least a small gym, or perhaps cover or partially defray the cost of gym memberships, to encourage physical fitness; some will offer an annual stipend for meeting some form of physical fitness testing standard.[5]Most Agencies offer some form of annual clothing allowance to help defray the costs of dry cleaning, repairing, purchasing uniforms and accessories.[6]Some Agencies may offer an annual bonus, depending on their policies, State laws, budget allocations, various standards to be met, etc.[7]Most Agencies offer the use of a firearms training facility, whether attended by range coaches or on the officer’s own time, “shoot/don’t shoot” and simulation training, realistic “shoot house” training with paint balls or simunition, additional decisional training, and additional ammunition to practice beyond the quarterly (whatever the Agencies’ policies are…) qualification process.[8]Many Agencies offer some sort of AFLAC-like income loss insurance, where if a covered health event requires the use of sick leave, the income loss insurance will kick in whatever the covered amount on the schedule of coverage would be, although these policies must usually be paid for by the member.[9]Most Agencies offer some level of tuition reimbursement or educational assistance, especially for training and education that is directly related to their profession.[10]Various benefits available to survivors of officers killed or severely disabled in the line of duty.[11]Many of these benefits are voluntary, and are paid for through either payroll deductions, or through union dues/additional union deductions, depending.Many Agencies provide a “cafeteria-like” menu of benefit options, along with certain group rate discounts, and varying amounts of “cafeteria cash” in each paycheck, beyond their pay, to help purchase medical coverage and other benefits. This cafeteria cash is often pre-tax, along with some other benefit options that are purchased using pre-tax money, resulting in a somewhat lower taxable gross income. The tax rules and other regulations, and union contracts, governing these options are often very complex…And, many Agencies will either pay the entire employee’s share of pension contributions (typically only to defined benefit plans), or match employee contributions (especially for newer pension plans and those using defined contribution plans) up to a certain amount.For example, I worked for a public safety agency that paid my entire 9% of gross pay pension contribution, while also paying another 9% as the employer contribution into my pension plan. In the same county, even in neighboring cities, there were other Agencies that did not use the same method, and their public safety officers paid more or less of their paycheck into their pension fund because their Agencies didn’t pay all of the employee’s contributions like mine did; some of those Agencies required 5–7% contributions out of the employees’ pay…which effectively made a 9% increase in my paycheck and put 18% above each paycheck into a tax-deferred defined benefit pension plan. That’s a benefit, too, as public safety pensions are among the most generous pensions left in either the public or private sector, less the military, federal civil servants, and certain highly paid specialists and executives.CONCLUSION: US law enforcement officers receive a wide array of possible benefits, from very generous pay and sweeping benefits and pensions, down to bare bones paychecks with nothing more than the state-mandated Workmen’s Compensation and Agency-issued equipment. It just depends on which of the 18,000 public safety agencies is the employer.Footnotes[1] https://www.bjs.gov/content/pub/pdf/nsleed.pdf[1] https://www.bjs.gov/content/pub/pdf/nsleed.pdf[1] https://www.bjs.gov/content/pub/pdf/nsleed.pdf[1] https://www.bjs.gov/content/pub/pdf/nsleed.pdf[2] City of L.A. Personnel Department[2] City of L.A. Personnel Department[2] City of L.A. Personnel Department[2] City of L.A. Personnel Department[3] Benefits of FOP Membership - FOPConnect[4] https://www.poam.net/app/uploads/2018/08/Police-Officers-WC-Rights.pdf[5] U.S. Fish and Wildlife Service[6] 9.050 - Clothing Allowance and Reimbursement for Personal Property[7] Benefits | Evansville Police Department[8] https://www.cji.edu/wp-content/uploads/2019/04/failureofpolicefirearmstraining.pdf[9] https://www.aflac.com/us/en/docs/workforce/viewpoint_government_agency.pdf[10] Benefits - Police[11] https://www.ncjrs.gov/pdffiles1/bja/fs000270.pdf

“What is ICD-10 (International Classification of Diseases, Tenth Revision)? - Definition from WhatIs.com”“The International Classification of Diseases, Tenth Edition (ICD-10), is a clinical cataloguing system that went into effect for the U.S. healthcare industry on Oct. 1, 2015, after a series of lengthy delays. Accounting for modern advances in clinical treatment and medical devices, ICD-10 codes offer many more classification options, compared with those found in its predecessor, ICD-9.The World Health Organization (WHO) owns, develops and publishes ICD codes, and national governments and other regulating bodies adopt the system. WHO publishes minor updates every year and major updates every three years.ICD-10 purpose and usesWithin the healthcare industry, providers, coders, IT professionals, insurance carriers, government agencies and others use ICD codes to properly note diseases on health records, to track epidemiological trends and to assist in medical reimbursement decisions.According to the American Health Information Management Association, ICD-10 provides better mapping from SNOMED CT, a multilingual vocabulary of clinical terminology that is used to capture the clinical data of a care episode. SNOMED CT to ICD-10 mapping can enable computer-assisted coding that improves the accuracy, efficiency and consistency of coding. ICD-10 procedure codes can also provide specific information about how a healthcare provider approached a medical procedure and what type of medical device was used.Why is ICD-10 important?ICD-10 codes provide more detailed information for measuring healthcare service quality, safety and efficacy. Because better data will be provided via the ICD-10 code set, it has the potential to improve the following:value-based reimbursement;outcome measurements;clinical, financial and administrative performance measurement;the design of payment systems and claims processing;reporting on new medical technology;improving reimbursement systems; andcare and disease process management.The adoption of the ICD-10 code set also allows for more accurate payment for new procedures, fewer rejected claims, fewer fraudulent claims, a better understanding of new procedures and improved disease management.Key differences between ICD-9 and ICD-10(Check out our video introduction to ICD-10 below.)The list of ICD-10 codes greatly expands classification options.For example, ICD-10-CM has 68,000 codes, compared with 13,000 in ICD-9-CM, according to the Centers for Medicare & Medicaid Services (CMS).ICD-10 codes also have alphanumeric categories, while ICD-9 has numeric categories. And ICD-9's codes are based on three to five letters and numbers, while ICD-10's are based on three to seven letters and numbers. The seventh character was added to further specify a diagnosis and most commonly captures data about the treatment phase, as follows:A (initial encounter). Although the name implies it is the patient's initial visit, initial encounter refers to the period during which the patient is receiving active treatment for a condition.D (subsequent encounter). Subsequent encounter refers to an encounter after the patient has received active treatment, during the recovery phase.S (sequela). Sequela refers to a complication or condition that is a direct result of an injury, such as a scar.Furthermore, with ICD-10, some titles have been renamed, chapters changed and certain conditions grouped together.ICD-10 codes also provide more detail about the patient's condition. For example, if a patient broke a wrist, ICD-9 did not specify whether it was the left or right wrist, while ICD-10 offers either option. ICD-10 also presents additional details on when a patient is seen by a caregiver and how an injury or disease is progressing or healing.ICD-10-CM vs. ICD-10-PCSIn the U.S., ICD-10 is split into two systems: ICD-10-CM (Clinical Modification), for diagnostic coding, and ICD-10-PCS (Procedure Coding System), for inpatient hospital procedure coding. These U.S.-specific adaptations conform to WHO's ICD-10 layout, while allowing for additional details found in U.S. healthcare. The U.S. took a similar approach with ICD-9-CM and ICD-9-PCS.Another difference is the number of codes: ICD-10-CM has 68,000 codes, while ICD-10-PCS has 87,000 codes.How are non-HIPAA and public health entities affected?All HIPAA-covered entities were required to transition to ICD-10. While non-HIPAA-covered entities aren't required to transition, they can still adopt the coding system, which could potentially help the noncovered entities expand into more detail on injuries. This added detail could then help organizations, like automobile insurers and workers' compensation programs, with injury classification and the coordination of benefits.The history of ICD-10 codesThe U.S. used ICD-9 from 1979 to 2015. In those 35-plus years, supporters of ICD-10 said its predecessor had become obsolete, didn't account for modern healthcare practices, and lacked ICD-10's specificity for clinical diagnoses and medical device coding.Work on ICD-10 first began in 1983 and was endorsed by the 43rd World Health Assembly (WHA) in May 1990. Some countries began using ICD-10 codes in 1994, with the U.S. being one of the last developed countries to adopt the revision.The transition to ICD-10The ICD-10 conversion in the U.S. was delayed by lobbying, politics and general opposition to the increased amount of codes in the newer set. Physicians, in particular, opposed the new revision, with groups like the American Medical Association lamenting the cost of ICD-10 implementation, believing it would take away resources from other areas. Below is a brief timeline of the delays that slowed down ICD-10 implementation:Jan. 16, 2009. The U.S. Department of Health and Human Services (HHS) published a final rule establishing ICD-10 as the new national coding standard, with an adoption date of Oct. 1, 2013.Aug. 24, 2012. HHS announced a delay in ICD-10 adoption from Oct. 1, 2013, until Oct. 1, 2014, to allow healthcare systems more time to prepare for the transition.March 2013. At the 2013 HIMSS (Healthcare Information and Management Systems Society) meeting, a CMS administrator said ICD-10 would not be delayed past Oct. 1, 2014.April 1, 2014. Then-President Barack Obama signed a Medicare reimbursement bill from Congress that included a delay in ICD-10 implementation from Oct. 1, 2014, until Oct. 1, 2015.ICD-10 vs. ICD-11WHO released an advance preview of ICD-11 on June 18, 2018, with 55,000 codes for causes of death, diseases and injuries. The new revision was designed to simplify the coding structure, so healthcare providers can more easily record medical conditions.This edition is also the first to be completely electronic, so it can integrate with electronic data sources and is free to download online for personal use. Experts can contribute to the revision process through the ICD-11 online platform, which will allow them to make comments and proposals for ICD categories and definitions.ICD-11 adds gaming disorder to the addictive disorders section and expands sections on allergies and immune system disorders, cancer, cardiology, dementia, diabetes and infectious diseases. The new revision will also include new chapters on sexual health and traditional medicine.ICD-11 will be presented at the WHA in May 2019 for adoption by countries and other parties, and it will go into effect on Jan. 1, 2022, if the WHA endorses it. However, adoptees are encouraged to begin planning their transition to ICD-11 now, which may include translating it into their language.Continue Reading About ICD-10 (International Classification of Diseases, Tenth Revision)With ICD-10, the medical industry can escape the pastICD overview from CMSCompare ICD-10-CM to ICD-9-CMHow the transition to ICD-10 codes will affect health ITWill the final rollout of ICD-10 benefit patient outcomes?Related TermsAmerican Health Information Management Association (AHIMA)The American Health Information Management Association (AHIMA) is a professional organization that promotes the business and ... See complete definition”“ ICD-10-CM (Clinical Modification) ““ The ICD-10-CM (Clinical Modification) is a system used by physicians and other healthcare providers to classify and code all ... See complete definition ICD-10-PCSThe International Classification of Diseases, 10th Revision, Procedure Coding System (ICD-10-PCS) is a U.S. cataloguing system for... See complete definitionHyperlipidemia: Symptoms, Causes, Treatment, and MoreWhat is hyperlipidemia?Hyperlipidemia is a medical term for abnormally high levels of fats (lipids) in the blood. The two major types of lipids found in the blood are triglycerides and cholesterol.Triglycerides are made when your body stores the extra calories it doesn’t need for energy. They also come directly from your diet in foods such as red meat and whole-fat dairy. A diet high in refined sugar, fructose, and alcohol raises triglycerides.Cholesterol is produced naturally in your liver because every cell in your body uses it. Similar to triglycerides, cholesterol is also found in fatty foods like eggs, red meat, and cheese.Hyperlipidemia is more commonly known as high cholesterol. Although high cholesterol can be inherited, it’s more often the result of unhealthy lifestyle choices.Understanding cholesterolCholesterol is a fatty substance that travels through your bloodstream on proteins called lipoproteins. When you have too much cholesterol in your blood, it can build up on the walls of your blood vessels and form plaque. Over time, plaque deposits grow larger and begin to clog up your arteries, which can lead to heart disease, heart attack, and stroke.Getting a diagnosisHyperlipidemia has no symptoms, so the only way to detect it is to have your doctor perform a blood test called a lipid panel or a lipid profile. This test determines your cholesterol levels. Your doctor will take a sample of your blood and send it to a lab for testing, then get back to you with a full report. Your report will show your levels of:total cholesterollow-density lipoprotein (LDL) cholesterolhigh-density lipoprotein (HDL) cholesteroltriglyceridesYour doctor may ask you to fast for 8 to 12 hours before getting your blood drawn. That means you’ll need to avoid eating or drinking anything other than water during that time. However, recent studies suggest that fasting isn’t always necessary, so follow your doctor’s instructions in regard to your particular health concerns.Generally, a total cholesterol level above 200 milligrams per deciliter is considered high. However, safe levels of cholesterol can vary from person to person depending on health history and current health concerns, and are best determined by your doctor. Your doctor will use your lipid panel to make a hyperlipidemia diagnosis.Are you at risk for hyperlipidemia?There are two types of cholesterol, LDL and HDL. You’ve probably heard them called “bad” and “good” cholesterol, respectively. LDL (“bad”) cholesterol builds up in your artery walls, making them hard and narrow. HDL (“good”) cholesterol cleans up excess “bad” cholesterol and moves it away from the arteries, back to your liver. Hyperlipidemia is caused by having too much LDL cholesterol in your blood and not enough HDL cholesterol to clear it up.Unhealthy lifestyle choices can raise “bad” cholesterol levels and lower “good” cholesterol levels. If you’re overweight, eating lots of fatty foods, smoking, or not getting enough exercise, then you’re at risk.Lifestyle choices that put you at risk for high cholesterol include:eating foods with saturated and trans fatseating animal protein, like meat and dairynot getting enough exercisenot eating enough healthy fatsobesitylarge waist circumferencesmokingdrinking alcohol excessivelyAbnormal cholesterol levels are also found in some people with certain health conditions, including:kidney diseasediabetespolycystic ovary syndromepregnancyunderactive thyroidinherited conditionsAs well, your cholesterol levels may be affected by certain medications:birth control pillsdiureticssome depression medicationsFamilial combined hyperlipidemiaThere’s a type of hyperlipidemia that you can inherit from your parents or grandparents. It’s called familial combined hyperlipidemia. Familial combined hyperlipidemia causes high cholesterol and high triglycerides. People with this condition often develop high cholesterol or high triglyceride levels in their teens and receive a diagnosis in their 20s or 30s. This condition increases the risk of early coronary artery disease and heart attack.Unlike people with typical hyperlipidemia, people with familial combined hyperlipidemia may experience symptoms of cardiovascular disease after a few years, such as:chest pain (at a young age)heart attack (at a young age)cramping in the calves while walkingsores on the toes that don’t heal properlystroke symptoms, including trouble speaking, drooping on one side of the face, or weakness in the extremitiesHow to treat and manage hyperlipidemia at homeLifestyle changes are the key to managing hyperlipidemia at home. Even if your hyperlipidemia is inherited (familial combined hyperlipidemia), lifestyle changes are still an essential part of treatment. These changes alone may be enough to reduce your risk of complications like heart disease and stroke. If you’re already taking medications, lifestyle changes can improve their cholesterol-lowering effects.Eat a heart-healthy dietMaking changes to your diet can lower your “bad” cholesterol levels and increase your “good” cholesterol levels. Here are a few changes you can make:Choose healthy fats. Avoid saturated fats that are found primarily in red meat, bacon, sausage, and full-fat dairy products. Choose lean proteins like chicken, turkey, and fish when possible. Switch to low-fat or fat-free dairy. And use monounsaturated fats like olive and canola oil for cooking.Cut out the trans fats. Trans fats are found in fried food and processed foods, like cookies, crackers, and other snacks. Check the ingredients on product labels. Skip any product that lists “partially hydrogenated oil.”Eat more omega-3s. Omega-3 fatty acids have many heart benefits. You can find them in some types of fish, including salmon, mackerel, and herring. They can also be found in some nuts and seeds, like walnuts and flax seeds.Increase your fibre intake. All fibre is heart-healthy, but soluble fibre, which is found in oats, brain, fruits, beans, and vegetables, can lower your LDL cholesterol levels.Learn heart-healthy recipes. Check out the American Heart Association’s recipe page for tips on delicious meals, snacks, and desserts that won’t raise your cholesterol.Eat more fruits and veggies. They’re high in fibre and vitamins and low in saturated fat.Lose weightIf you’re overweight or obese, losing weight can help lower your total cholesterol levels. Even 5 to 10 pounds can make a difference.Losing weight starts with figuring out how many calories you’re taking in and how many you’re burning. It takes cutting 3,500 calories from your diet to lose a pound.To lose weight, adopt a low-calorie diet and increase your physical activity so that you’re burning more calories than you’re eating. It helps to cut out sugary drinks and alcohol, and practice portion control.Get activePhysical activity is important for overall health, weight loss, and cholesterol levels. When you aren’t getting enough physical activity, your HDL cholesterol levels go down. This means there isn’t enough “good” cholesterol to carry the “bad” cholesterol away from your arteries.You only need 40 minutes of moderate to vigorous exercise three or four times a week to lower your total cholesterol levels. The goal should be 150 minutes of exercise total each week. Any of the following can help you add exercise to your daily routine:Try biking to work.Take brisk walks with your dog.Swim laps at the local pool.Join a gym.Take the stairs instead of the elevator.If you use public transportation, get off a stop or two sooner.Quit smokingSmoking lowersTrusted Source your “good” cholesterol levels and raises your triglycerides. Even if you haven’t been diagnosed with hyperlipidemia, smoking can increase your risk of heart disease. Talk to your doctor about quitting or try the nicotine patch. Nicotine patches are available at the pharmacy without a prescription. You can also read these tips from people who have quit smoking “.“2020 ICD-10-CM Diagnosis Code E78.5”“Hyperlipidemia, unspecified. 2016 2017 2018 2019 Billable/Specific Code. E78.5 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. The 2018/2019 edition of ICD-10-CM E78.5 became effective on October 1, 2018”.“ 2020 ICD-10-CM Diagnosis Code E78.2 ”“ Mixed hyperlipidemia 1 E78.2 is a billable/specific ICD-10-CM code that can be used to indicate a diagnosis for reimbursement purposes. 2 The 2019 edition of ICD-10-CM E78.2 became effective on October 1, 2018. 3 This is the American ICD-10-CM version of E78.2 - other international versions of ICD-10 E78.2 may differ “.“ ICD 10 code for hyperlipidemia - E78.5 ““ ICD 10 code for hyperlipidemia - E78.5. Hyperlipidemias are also classified according to which types of lipids are elevated, that is hypercholesterolemia, hypertriglyceridemia or both in combined hyperlipidemia. Elevated levels of Lipoprotein may also be classified as a form of hyperlipidemia “.