What does a "Flagged" claim mean?

In the Claims view of your HealthLock Member Portal, any claim or bill marked as “Flagged” indicates there may be a potential savings opportunity.

Claims are typically flagged when our system detects possible overbilling, a denial, or key terms such as ER, surgery, or procedure that often warrant further review.

For select plans, members can request assistance from a HealthLock auditor to review flagged claims and help ensure accuracy.

What to Do if You Receive a Notification About a Flagged Claim

If you receive an email or text message notifying you of a flagged claim:

1. Log in to your HealthLock Member Portal.
   
   

2. Locate the flagged claim and click “LOWER MY BILL” if you’d like HealthLock to investigate.
   
   

3. If prompted (depending on your plan), accept the shared savings agreement to proceed.
   
   

4. Once submitted, your Case will be assigned to a HealthLock auditor, who will review the claim and notify you of the outcome.
   
   

If savings are found due to an error or overbilling, a shared savings fee (for example, 20%) will apply based on your plan. If savings are identified due to fraud, no shared savings fee will be charged.