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Glossaries |
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For many of us, medical and health insurance terms are unfamiliar or complex. Our glossaries define some of those terms. |
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Abuse
Improper or excessive use of program benefits or services by providers or beneficiaries. Abuse can occur, intentionally or unintentionally, when services are used which are excessive or unnecessary; which are not the appropriate treatment for the patient's condition; when cheaper treatment would be as effective; or when billing or charging does not conform to requirements. It should be distinguished from fraud, in which deliberate deceit is used by providers or consumers to obtain payment or services which were not actually delivered or received, or to claim program eligibility. See also "Fraud."
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