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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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Fraud
Intentional misrepresentation by either providers or beneficiaries to obtain services or payment of services. Fraud may include deliberately misrepresenting need or eligibility; providing false information concerning costs or conditions to obtain reimbursement or certification; and claiming payment for services that were never delivered or received. Fraud is illegal and carries a penalty when proven. See also "abuse."
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