How will HealthLock help with traditional Medicare and Medicare Advantage?

HealthLock’s auditors can help save you time and money by identifying billing errors, assisting with appeals, and ensuring accurate claim processing across both Traditional Medicare and Medicare Advantage plans. Here are a few examples of how we can help:

• Appeals:
  Our auditors can file appeals for denied Medicare services, from Level 1 up to the Federal level. Unlike many other carriers, Traditional Medicare does not reprocess claims or send them back for review—so our expertise helps ensure your appeal is filed correctly and efficiently.

• Medicaid:
  Medicaid claims fall under each state’s program and assigned group plan, following state-specific guidelines. Our team understands these variations and helps ensure compliance while pursuing the best possible outcome for your claim.

• Inpatient Hospital Services:
  Our auditors can monitor your Lifetime Reserve Days (LRDs) and notify you when you’re approaching your limits to help minimize out-of-pocket costs.

  • Original Medicare covers up to 90 days of inpatient hospital care per benefit period.

  • You also have an additional 60 lifetime reserve days, which can be used only once.

  • You’ll pay a coinsurance for each LRD used ($838 per day in 2025).

• In-Network Provider Services (Denied Charges):
  If services from an in-network provider are denied, our auditors can work directly with the provider to reopen or reestablish consideration of those charges.