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Glossary Of Terms |
Please Note: This information is a general reference tool. All terms, conditions and amounts may not be applicable to your benefit plan. Please refer to your Plan Document for a complete listing of terms, conditions, coverage and exclusions of your benefit plan.
Terms Beginning with the Letter "S"
Sickness is a person’s Illness, disease, or Pregnancy (including complications).
Skilled Nursing Facility is a facility that fully meets all of these tests:
- It is licensed to provide professional nursing services on an inpatient basis to persons convalescing from Injury or Sickness. The service must be rendered by a registered nurse (R.N.) or by a licensed practical nurse (L.P.N.) under the direction of a registered nurse. Services to help restore patients to self‑care in essential daily living activities must be provided.
- Its services are provided for compensation and under the full‑time supervision of a Physician.
- It provides 24 hour per day nursing services by licensed nurses, under the direction of a full‑time registered nurse.
- It maintains a complete medical record on each patient.
- It has an effective utilization review plan.
- It is not, other than incidentally, a place for rest, the aged, drug addicts, alcoholics, mental retardates, Custodial Care or educational care or care of Mental Disorders.
- It is approved and licensed by Medicare.
This term also applies to charges incurred in a facility referring to itself as an extended carefacility, convalescent nursing home, rehabilitation hospital,or any other similar nomenclature.
Spinal Manipulation/Chiropractic Care means skeletal adjustments, manipulation or other treatment in connection with the detection and correction by manual or mechanical means of structural imbalance or subluxation in the human body. Such treatment is done by a Physician to remove nerve interference resulting from, or related to, distortion, misalignment or subluxation of, or in, the vertebral column.
Substance Abuse is regular excessive compulsive drinking of alcohol and/or physical habitual dependence on drugs. This does not include dependence on tobacco and ordinary caffeine‑containing drinks.
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