Accessibility: A member's ability to obtain health care, taking into consideration the availability of health services, their acceptability to the member, the location of the health care services, the availability of convenient transportation, the hours of operation, and the cost of care.

Active Care: Modes of treatment requiring "active" patient involvement, participation and responsibility on the part of the patient.

Allied Specialty: Allied specialty care is a term used by Triad to define the various healthcare disciplines that offer "hands on," therapeutic, services to people complaining of a wide class of conditions defined by either pain or loss of physical function.

Ancillary Procedures: All therapeutic procedures other than spinal manipulation, as permitted by individual state law/regulations and appropriate for patient management.

Cervical: The cervical spine is made up of the first seven vertebrae in the spine. It starts just below the skull and ends just above the thoracic spine. The cervical spine has a lordotic curve (a backward "C"-shape) - just like the lumbar spine. The cervical spine is much more mobile than both of the other spinal regions - think about all the directions and angles you can turn your neck.

Medical Necessity: Appropriate care is proper and necessary for the diagnosed condition, when it is shown to be curative or rehabilitative for the condition, and reflects accepted standards of good practice with the scope of practice allowed by state law/ regulations. Care that will not be certified for reimbursement includes care that is inappropriate for a given condition; care that presents risks in excess of expected benefits; care this is obsolete, experimental, or investigational.

Dizziness: Dizziness may be experienced as lightheadedness, feeling like you might faint, being unsteady, loss of balance, or vertigo.

Extremities: The bones by which the upper and lower limbs are attached to the trunk constitute respectively the shoulder and pelvic girdles.

Headache: Headache is defined as pain in the head that is located above the eyes or the ears, behind the head (occipital), or in the back of the upper neck.

Health Professional: An individual who:

Loss of Motion: The inability of a joint to move through it's normal range of motion.

Lumbar: In anatomy, lumbar is an adjective that means of or pertaining to the abdominal segment of the torso, between the diaphragm and the sacrum (pelvis). The five verterbrae in the lumbar region are the largest and strongest in the spinal column.

Maintenance/Preventative Care: A regimen designed to provide for the patient's continued well-being or for maintaining the optimum state of health while minimizing recurrence of the clinical status. Includes treatment procedures considered necessary to prevent the development of clinical status.

Maximum Supportive Benefit (MSB) MSB is reached when the recommended regimen of supportive care fails to maintain stability in the condition severity indicators used to measure pain and function or, the risks of supportive care outweighs its benefits, i.e. physician dependence, somatization, illness behavior, or secondary gain the patient will be considered as having reached Maximum Supportive Benefit.

Maximum Therapeutic Benefit (MTB): The point in treatment where patient has ceased to progress dn is not expected to progress any further. Following 4 to 8 weeks of the patient's symptoms/ condition having reached a plateau, the patient will be considered at MTB. NOTE: Reimbursement for care beyond MTB (Supportive or Maintenance care) is dependent upon policy language and plan benefits.

Pain: Pain is an uncomfortable feeling that tells you something may be wrong in your body. Pain is your body's way of sending a warning to your brain. Your spinal cord and nerves provide the pathway for messages to travel to and from your brain and the other parts of your body.

Pain Management: Pain management is an extremely important part of health care, as patients forced to remain in severe pain often become agitated and/or depressed and have poorer treatment outcomes.

Passive Care: Application of treatment/ care modalities by the provider to the patient, who "passively" receives care.

Physical Therapy: Physical therapy is a unique and vital health profession concerned with health promotion, prevention of physical disabilities and the habilitation/rehabilitation of person disabled by pain, disease, or injury. Physical therapy is defined as the assessment, evaluation, treatment and prevention of physical disability, pain and movement dysfunction resulting from injury, disease, disability, or other health related conditions.

Rehabilitative Care: That phase of therapeutic care necessary for re-education or functional restoration of an injured body system or part. It may include treatment that relieves an exacerbation, but there must be continuing documented subjective and objective signs of improvement.

Supportive Care: Treatment for patients having reached maximum therapeutic benefit, where periodic trials of therapeutic withdrawal fail to sustain previous therapeutic gains that would otherwise progressively deteriorate. Supportive care follows appropriate application of active and passive elements including lifestyle modifications. It is appropriate when rehabilitative and/or functional restorative and alternative care options, including home-based self-care and lifestyle modifications, have been considered and attempted. Supportive care may be inappropriate when the risk of supportive care outweighs its benefits, i.e. physician dependence, somatization, illness behavior, or secondary gain.

Therapeutic Care: The treatment necessary to establish a stationary status of the patient at maximum therapeutic benefit.

Therapeutic Necessity: For the purpose of defining the necessity of chiropractic services administered under TRIAD contracts: Medial Necessity, and Therapeutic Necessity shall be considered equivalent terms; and Therapeutic Care and Curative Care shall be considered equivalent terms; and Maximum Medial Improvement and Maximum Therapeutic Benefit shall be considered equivalent terms. A health care condition exists in the presence of an impairment (illness/injury) evidenced by recognized signs an symptoms, and likely to respond favorably to the treatment/ care planned.

Thoracic Spine: The thoracic spine is made up of the middle 12 vertebra of the spine. These vertebrae connect to your ribs and form part of the back wall of the thorax (the ribcage area between the neck and the diaphragm).

Torso: An anatomical term for the greater part of the human body without the head and limbs. It is also referred to as the trunk. The torso includes the chest, back, and abdomen.