Pod Insights The Clark Howard Podcast 07.07.25 Epidemic Of SCAMS On Social Media / Fight Health Insurance Denials About this episode From influencers peddling goods to “finfluencers” employing bot farms to push fake posts about hot stocks - schemes and scams are rife on social media, and public users aren’t the ones getting rich. Also today, why you should never take a health insurance claim denial lying down! Clark explains the denial game, and how most of the time, filing an appeal works in your favor. Social Media Scamdemic: Segment 1 Ask Clark: Segment 2 APPEAL Health Insurance Denials: Segment 3 Ask Clark: Segment 4 Mentioned on the show: Meta Battles an ‘Epidemic of Scams’ as Criminals Flood Instagram, Facebook - WSJ Tom’s Guide - The Oura ring just got a new rival What Should You Do if Your Insurance Claim Is Denied? No Surprises Act Consumer Advocate Toolkit Health Insurance Archives - Clark Howard Health Archives - Clark Howard Clark.com resources Episode transcripts Community. Clark.com / Ask Clark Clark.com daily money newsletter Consumer Action Center Free Helpline: 636-492-5275 Learn more about your ad choices: megaphone.fm/adchoices Learn more about your ad choices. Visit megaphone.fm/adchoices
Transcript 0:00 Speaker 00 This episode is brought to you by Indeed. You're ready to level up your business, but the pressure to find the right person to make that happen is intense. Indeed sponsored jobs can help carry the load. It boosts your job post to help it reach quality talent fast. Cut through the chaos with Indeed sponsored jobs. Get a $75 sponsored job credit at indeed.com/podcast. Terms and conditions apply. Hiring now? Then this is a job for Indeed sponsored jobs.
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1:04 Speaker 02 It's my pleasure to welcome you here to the Clark Howard Show, where our mission is to serve you with advice and information that empowers you so you make better financial decisions in your life. Today, we're going to start talking about how you have to be so careful on social media as it's become one of the main platforms for scamsters to cheat you. And we're going to talk about insurers delaying, delaying, denying, and what you do about it when you have a health insurance claim and they're just not treating you right, in your opinion.
1:46 Speaker 02 Let's talk about the epidemic, if you will, of scams. I keep seeing that phrase exactly because it's catchy and it's accurate. Because people let down their guards on social media in ways that we haven't in the past done with strangers. You know, it used to be that the main Entryway to scams was what was called affinity fraud. It was where an individual would gain your confidence and then you'd suspend your normal disbelief and hook, line and sinker buy whatever junk or con or ripoff they were selling.
2:29 Speaker 02 It's just been a pattern of humanity for not just now, for centuries, that people would get taken by a con artist who would befriend them. What is so curious to me is how people are getting taken on social media and the top places people seem to be getting taken are Facebook and Instagram. Not because there's something inherently evil about Facebook or Instagram. They're so crazy popular that the scamsters are going there to those two platforms electronically
3:12 Speaker 02 creating followings or befriending people and then scamming them. And some things are out and out scams. Others are more gray. How do you put the category of a paid influencer? Somebody who has developed a loyal following, who's really great at whatever, and then they start touting something they're getting paid for and because of your emotional connection to them for the great information they have about fashion or design or whatever it is,
3:51 Speaker 02 that suddenly they do a rack on something completely unrelated and you go ahead and you're like, yeah, gotta get it because she loves it or he loves it or whatever. And remember, they're being bought and paid for that. They don't know they're scamming you many times, but the result is the same. And then, don't get me started on the fanfluencers. Finfluencer is a, what a funny contraption of a word. It's where people are touting different investment opportunities, different investment systems, whatever. And, you know, we've had this with phony baloney investing schemes forever.
4:36 Speaker 02 You know, I could, every day, I read a report that appears in Barron's magazine and it will talk about, it's geared towards the investment advisory business. It'll talk about various scams that brokers and investment people have stolen people's money through. I mean, it's almost like a training platform for people who want to steal people's money. And those were traditional ways that they write about in Barron's through the investment community. What's happening on social media is people just say that they're whatever they are. And win people's confidence and steal their money. This can be so many different things.
5:19 Speaker 02 It can be just people running straight out scams, whatever, on Facebook and Instagram. And again, I don't hold Facebook and Instagram responsible for this. They are platforms that they make available to people. If they find out that somebody's dirty, they should pull them down. But it's not the platform's fault that scamsters have figured out that this is such a lucrative area. What I'm asking of you is for you to be skeptical when people start befriending you on Facebook or you really get caught up following somebody on Instagram.
5:59 Speaker 02 And you end up, before you know it, with money of yours that ends up being money of theirs.
6:08 Speaker 03 All right, speaking of scams, Ray in Texas wrote in with this one. I want to make Clark aware of an active scam that's going on in Texas. Unfortunately, I was a victim. The real irony is, I know to do my full research and I neglected to do so. I hope that Clark covers this and here's my story. In March, I came across a Facebook post regarding a wine tasting festival and decided to visit the website to verify its authenticity. After reviewing the site, I registered for the event, paying $29.71.
6:37 Speaker 02 $29.71?
6:38 Speaker 03 No, no, $29.71.
6:40 Speaker 02 Oh, good. Okay. That's a cheap lesson from a scam if this is going to turn out to be a scam.
6:46 Speaker 03 The festival was scheduled for April 26th of this year. However, on April 25th, I received an email from the company informing me the event had been canceled. I promptly responded to the email and after several exchanges, I was assured that a refund would be issued. Unfortunately, I've yet to receive this refund. Following this experience, I conducted some research online and discovered that this company has a reputation for scamming individuals, as evidenced by their F-rating on the Better Business Bureau and a total of 112 complaints filed in the last three years, primarily concerning event cancellations without refunds. They are advertising on both Facebook and Google.
7:22 Speaker 02 Ray, thank you for this. I'd say these are not the smartest con artists, because if they're stealing $30 a person, they'd have to go to a lot of effort to steal from a lot of people to make it lucrative enough to do it. It's possible these people are just incompetent, but there's no excuse not giving refunds. And you said you feel like you didn't do the proper research. I mean, what would that be? You think about a wine festival. If they were asking you for hundreds and hundreds of dollars, yeah, I would have expected you to do more research. But you like wine, sounded cool, and it was 30 bucks.
8:07 Speaker 02 Don't beat yourself up. There's a threshold above which, whatever the pain point is for you, that you do more digging, you do more research. And even if they're not con artists, you would know from the research you did after the fact that they are, at the very least, really terrible business people.
8:27 Speaker 03 For sure. Okay, Larry in Florida says, Clark talked about gas cars. I would like him to let us know how much it is to charge electric cars and how much a week or month it will cost.
8:36 Speaker 02 So that is one of the most complicated things to answer. And I should point out that the public's attitude in the United States towards electric vehicles has been going down four years in a row. I've seen the most recent polling, I think it was by AAA, and the percent of Americans that are really interested in buying an electric vehicle is the lowest it's been in half a decade. The reasons are all the things that no one can answer easily. You just ask me a simple question. You look and you see at a gas station, "Oh, it's this much a gallon." But you ask me, "How much does it cost to charge an electric car?" I can't answer that in 15 minutes. You couldn't, right?
9:20 Speaker 03 I couldn't, and I charge mine in my garage.
9:22 Speaker 02 Now, that's cheap. 80% of charging takes place at someone's home, and then you're paying a fraction of the cost, effectively per mile, for the conversion of electricity and a range of miles on an electric car versus range of miles filling up at a gas station. But when it involves a road trip, where are you going to charge it? When it involves knowing what that charge is going to cost, people who live in apartments and have to use public chargers, you're at the mercy of how much it is in that community to use
10:01 Speaker 02 that public charger. So there is no simple answer to this question. What is important is that an electric motor, the energy put in, 90-plus percent of it is then used to operate the vehicle, moving it forward. A gas engine, 3/4 of the fuel you buy is burned off, producing no forward motion in your vehicle at all. That's why electric vehicles to operate are much cheaper, plus they don't have all the parts. But this story is so confusing to people that it's really hard right now to get people excited about buying electric. You know what Americans have done, though, in reaction?
10:46 Speaker 02 Of hybrid vehicles in the United States has skyrocketed. Before all the conversation started with electric, almost nobody ever bought a hybrid. And now hybrids are ultimately going to be the dominant powertrain in the United States. Because people get the idea of traveling for a lot less per mile. And for many people, the gas engine is so comfortable. And you know how it works and all that. You know what you're going to have to pay to fill it up. The hybrids are for many people in America, the compromise. For me, having driven electric vehicles now for 14 years, I can't imagine driving anything else.
11:31 Speaker 03 Okay, a couple about your Oura ring Clark. First, Tom in Illinois wanted to tell you Clark loves the Oura, but check out this. The Oura ring just got a new arrival with a titanium design and 24/7 biometric tracking with no subscription required. And then here's a link there for you to check out this product.
11:49 Speaker 02 I should tell you, I've been reading reviews. There are now a number of companies from big like Samsung to small tech startups. Offering their versions.
11:59 Speaker 03 It's the Acer FreeSense Ring.
12:01 Speaker 02 That one I've not heard of, but Oura has created some vulnerability for itself. By having monthly dues for the data. I'm grandfathered in because I've been an Oura wearer for more than five years. So as long as I stick with the generation I'm on, which is the three, I don't have to pay the fees. When this one dies, then I'm going to be a free agent and I will consider one of the Oura competitors. That don't charge the $60, I think it's $60 a year or $70 a year fee for data.
12:37 Speaker 03 Okay. And then Nitti in North Carolina says, Clark, thought this would be a fun read addressing your Oura ring craze. Read this on Kim Commando's newsletter, destroying my mind. That's how 22 year old Sarah Hills felt about her Oura ring. Every spike in heart rate or dip in her readiness score sent her into a panic. It's called Oura paranoia. And she's not alone. Oura's own head of science says he takes breaks from wearing his ring. You might want to do that with a wearable too. I doubt this will faze you and give you an Oura paranoia, knowing that you are loaded with smartwatches too, and love that, even if Oura's own head of science takes a break from wearing it. And we do joke that like, you could wake up feeling good, but if your Oura gives you a bad score,
13:20 Speaker 03 you're like, oh my gosh, my day is, I feel terrible.
13:23 Speaker 02 I have no idea when I wake up in the morning and I see my Oura rating, if it's going to be good or bad. You know, it comes up with data on how I sleep, kind of like a health score. They call it a readiness. And it's just so weird from day to day. My readiness today is very high. I got a 91. My sleep score was an 85. My activity is a 98. My heart rate's really high right now, but it was not overnight.
13:54 Speaker 03 Because you have Oura paranoia.
13:55 Speaker 02 But my resting heart rate, look at it day by day. I had terrible numbers yesterday, and my overnight heart rate was high. But generally, I've found that I'm competitive with myself anyway. And the Oura is like a game for me. And it doesn't, I don't develop Oura paranoia.
14:18 Speaker 03 I think you need a smartwatch and Oura detox like weekend, where you just don't have any of it. You don't worry about your sometime.
14:26 Speaker 02 There's this one.
14:27 Speaker 03 All right, turn them in. This is the, which one's this? The Samsung?
14:30 Speaker 02 Samsung. This is the Garmin. I've been Garmin longer than anything else.
14:34 Speaker 03 And your Oura.
14:35 Speaker 02 There's my Oura.
14:35 Speaker 03 All right.
14:36 Speaker 02 Okay, here's my brain.
14:38 Speaker 03 You can go 24 hours.
14:40 Speaker 02 I'm not feeling any bad reaction to it at all.
14:45 Speaker 02 No, I guess, I guess that's true, that it would be helpful for me to detox from all the overload of data I look at every day.
14:55 Speaker 03 Oh my God, you're getting dings on both of these watches right now. Wow.
14:59 Speaker 02 Really?
15:00 Speaker 03 This is very distracting.
15:02 Speaker 02 Really? I don't even notice that they're dinging or anything. We're going to see if I can go, we'll try and experiment, we'll see if I can go 24 hours without any tracking at all.
15:12 Speaker 03 Okay.
15:13 Speaker 02 Maybe that's when I'll go crazy.
15:15 Speaker 03 I know.
15:16 Speaker 02 With no tracking devices.
15:18 Speaker 03 Clark goes dark.
15:22 Speaker 02 We'll see. Coming up ahead, this is not a laughing matter because I wear this stuff for health. How about when you're sick and then you get the bill, then you got a lot sicker. What do you do?
15:37 Speaker 00 This episode is brought to you by Indeed. You're ready to level up your business, but the pressure to find the right person to make that happen is intense. Indeed sponsored jobs can help carry the load. It boosts your job post to help it reach quality talent fast. Cut through the chaos with Indeed sponsored jobs. Get a $75 sponsored job credit at indeed.com/podcast. Terms and conditions apply. Hiring now? Then this is a job for Indeed sponsored jobs.
16:08 Speaker 04 Low energy, unfocused, foggy, you might be dehydrated. Gatorade Zero powders have been scientifically designed to help improve hydration balance in the body with a clinically proven electrolyte blend and no artificial colors or flavors. Great tasting hydration, no matter where you're going. Shop now online or at retailers nationwide. Gatorade hydrates better than water. Is it in you? Symptoms noted are signs of mild to moderate dehydration. Consult a healthcare professional if symptoms persist.
16:37 Speaker 02 You spend a lot of money for health insurance, or your employer is spending a lot of money for health insurance. You only see part of that with the portion they bill you for it. And then you got copays and deductibles and blah, blah, blah, blah, blah. And then the chips are down and you need care. Or you receive care and then you get a denial for payment or a refusal to approve something. Do you know that the best guess in the industry is roughly 1 in 6 claims are now denied by health insurers? 1 in 6. This is a game on their part. What happens with those 1 in 6 claims?
17:21 Speaker 02 Do you know that less than 1% of people do anything when a claim is denied? Less than 1%. Less than 1 out of 100 people. You say, "Oh, well, insurance doesn't want to pay, so I'm just going to get sick or I'm going to have this collection of you see calling me about a bill." Don't roll over. Don't roll over. You know that if you appeal, insurers know that 99% plus of people just roll over on them. What happens with people who stand up to the health insurance bully? What happens with bullies? Most of the time, their bark is worse than their bite.
18:04 Speaker 02 So when you appeal, depending on whose study you believe, 3 out of 4 times or 4 out of 5 times, you're going to win your appeal because the insurer is gaming you. They're playing games with you. And the deal is, when you have a small routine claim, goes right through the system automatically. It's when, and who knows at each insurer what the black box is when they decide, "Hey, we're going to mess with people because this is so expensive." But it gets to the point that the insurer is going to not approve it just because they're not going to approve it. And I don't know if you know the scam with the medical review
18:47 Speaker 02 that happens with a lot of insurers, where they will have an in-house medical professional whose job is to turn claims down. That is their job to turn claims down. So you talk to doctors in practice, they'll tell you how much of their time is now wasted trying to get a procedure approved for a patient. The whole thing is set up to wear people down and just go away. But it's your money. You or your employer paid for you to have that insurance. And you're in a contract for that insurance.
19:30 Speaker 02 And the insurer behaving dishonestly, unethically, becomes your problem. If you roll over and say, oh, well, you know, a lot of times the squeaky wheel gets the grease. And there's no more squeaky wheel than medical care. And so when you get that denial, you need to appeal. Because again, most of the time, remember, if people went on appeal, three quarters to 80% of the time, it means the insurer wasn't behaving ethically and in good faith in the first place. So once you present your documentation, or the medical provider provides that documentation
20:13 Speaker 02 to you, you then get that claim paid. The worst of all, though, is the stall when somebody needs expensive care. The insurer just doesn't want to pay. And they're waiting you out, hoping you die, so they don't have to pay. And that's not okay. And if you are too ill to fight your own battle, because sometimes you could be too sick to really fight for the coverage and care you need, that's when a family member or a friend needs to step up and be your advocate.
20:46 Speaker 03 All right, well, I have some questions that are related here, Clark. Ross in Illinois says, I received a $2,700 bill for a six-mile ambulance ride between two branches of the same hospital.
20:58 Speaker 02 Whoa.
20:58 Speaker 03 My child was not in a life-threatening situation, and I offered to drive him myself, but the ER staff said they couldn't allow it. They warned me it would have to be treated as a new case, and even hinted that child services might get involved.
21:10 Speaker 02 Come on.
21:11 Speaker 03 I felt totally cornered. My insurance only covered $500. What are my rights here? And how can I fight or negotiate this outrageous bill?
21:20 Speaker 02 I don't know what happened with the lobbyists with the ambulance industry. But they were carved out of the No Surprises Act. No Surprises Act is something that is a term surprisingly few people have heard of, and it's even harder to understand the provisions of it. But it does not offer the ability to have help in negotiating an ambulance charge. Although roughly about a third of the nation's states have the equivalent of their state system for no surprises on an ambulance charge. Illinois does have protections for public and private ambulance services,
22:02 Speaker 02 but it's only for people in HMO versions of insurance policies. What you do is you you try to negotiate not with a collection agency. You negotiate with the ambulance provider itself. If your health insurance is not considered in Illinois to be an HMO plan. And that's what we have here is it's haphazard with states that represent about 65% of the nation's population, but only a third of the states. The big states, Texas, Florida, California, New York, Illinois, all have ambulance surprise act kind of policies.
22:44 Speaker 02 So if you get a big ambulance bill, about two thirds of Americans will be covered. The other thirds, it's all about the negotiation that you do over the bill. And the hospital's strong arming you when your child was not in a life threatening situation. I don't know the circumstance, but how weird that is for them to behave that way.
23:08 Speaker 03 Okay, Dan in Wisconsin says, "The continuing revelations about UnitedHealth's patient treatment practices have made me increasingly uncomfortable with health insurance in general. I am able to choose my own insurer, but how do I know my other options aren't doing the same thing if I find myself needing major medical care? Don't all insurers have the same incentive to prevent me from getting the care I pay for? I know I need to be insured to protect myself, but what if the insurers won't hold up their end of the bargain?" Then what's the point?
23:35 Speaker 02 Well, I mean, you're, you're giving an additional bit of ammunition to what I was talking about the top. I mean, routine stuff, insurers do what they're supposed to do. It's when the big thing comes along that insurers aren't behaving. But again, you heard what I said. I mean, they turned down one in six claims and nobody does anything about it among consumers, among patients. You be that person who does something about it and you're going to get the insurance to do what it's supposed to. Three quarters or more of the time. So the important thing that I can do is to let you know what's going on behind the curtain. And that is that insurers are playing dirty pool.
24:19 Speaker 02 So what you have to do is you've got to know how to play pool better than they do. That's why you immediately exercise your rights to appeal under your plan. Period. I mean, that's what's involved.
24:33 Speaker 03 I have to just quick success story for me on this, and I have more to appeal that I haven't yet for my daughter. But my son, I submitted a bunch of bills from a provider and they rejected it. And I called and they just said, they were looking at it and trying to figure it out. And they just said, well, you know, and I said, no, this was, I provided everything. And she said, the reason stated is that you didn't provide dates of service on this. So I pulled up the document. I was like, they're on there. And she pulled it up and she was like, oh, they are. Resubmitted it and now we just got finally paid months later. It's just, you know, you just don't know the reason. So it's just frustrating.
25:09 Speaker 02 The reason is that they're playing dirty. I mean, that's the reason. The rest of it is all details and you don't let them wear you down. How much money was involved in these bills?
25:20 Speaker 03 Over a thousand dollars.
25:22 Speaker 02 Yeah. Do you have a thousand dollars just to say, ah, well over it? You don't. You fight for yourself. And really the problem is the financial incentives are wrong in capitalism. Capitalism works best when financial incentives are aligned. But the system we have right now for healthcare in the United States, all the financial incentives are misplaced. Hospitals, their only incentive is to run up as big a bills as they possibly can. Insurers incentive is to not pay for anything that they can avoid paying for. Both are completely wrong.
26:01 Speaker 02 We have a health system that's too expensive, too hard to use, and too difficult for patients to navigate. And so we've got some work to do here. We've got to make this work. You know, it's almost 20% of the US economy now. Any other country, the largest that healthcare spending is, I think is 8.5%.
26:22 Speaker 03 Tim in Florida says, Clark, I recently had a medical emergency that required a 911 call and transport to the hospital. I have insurance, but I would find out several days later, after being discharged, that the hospital I was taken to is out of my insurance plan's network. I was in the hospital for three days. Had this been an in-network, my deductible would have been $3,000, which I actually paid while I was in the hospital. Since I was out of network, my deductible is $9,000. So basically, because I was taken to an out-of-network hospital, I'm on the hook for the additional $6,000. This seems very unfair, as I had no say at all as to which hospital I was being taken to. I've tried to negotiate with the hospital concerning the bill, and all they will do is allow me to set up a payment
27:03 Speaker 03 plan. I've been making very small monthly payments, but not the $250 a month the hospital is asking for. Now they are threatening to send my outstanding bill to collections.
27:12 Speaker 02 So, Tim, you're a little late in this game, and the fact that you're writing means that you recovered, and I'm glad for that. But you are exactly what the No Surprises Act was designed for, and specifically covers your situation. I want you to look up the No Surprises Act. There are lots of medical advocacy organizations that explain how you use the No Surprises Act to deal with this bill. The reality is, your insurer and the hospital are not on your side here, because it seems that nobody has considered where
27:54 Speaker 02 the No Surprises Act fits, and what you should be out of pocket here. So... I think No Surprises Act again is complicated. I think that you are not liable for this extra $6,000, but you're going to have to look at your situation and see if in fact, the bill does step in for you in this case. The bill, meaning the No Surprises Law.
28:23 Speaker 03 So another quick thing, Clark, that I've noticed, and I'm wondering what your take is on this, is that if you go to an out of network doctor, for example, two examples here. My therapist doesn't take insurance, so I pay her $170 if I go see her. Or my son went to a medical doctor who's an expert, not in network. I have to pay $250 upfront. So both of those I pay for upfront. I file insurance and the EOBs, Explanation of Benefits, say, we saved you, we negotiate, we saved you this much money. Like, say it's $100 on the $170 charge. So your responsibility is 70. So toward your high deductible, you've paid $70. But really, I've paid 170. So why do they do that? For example, same thing with my son's medical doctor.
29:07 Speaker 03 They're like, oh, that should only be $100. So you've paid 100 out of your deductible, but really I've paid 250. What is that?
29:15 Speaker 02 Well, because you went out of network, your coverages are not nearly as generous.
29:20 Speaker 03 Right, and they're not really negotiating on my behalf. That's kind of the sentence that kills me. Because I'm like, you didn't negotiate anything, right? Is that crazy?
29:27 Speaker 02 I guess that's pretty much true.
29:29 Speaker 03 Okay, anyway, sorry, this is my beef.
29:32 Speaker 02 Again, healthcare in the United States is inefficient, crazy costly, and nobody's happy with it. Providers aren't happy with it. Consumers aren't happy with it. That's why I call patients, we're consumers.
29:44 Speaker 03 Yes.
29:45 Speaker 02 Employers aren't happy with what it's costing them. And where, where are the guts and the politicians to do something about it? You don't hear anything about it, do you?
29:57 Speaker 03 No.
29:58 Speaker 02 Yeah, so I'm ready to fix it. I knew how.
30:02 Speaker 03 I know, really.
30:03 Speaker 02 But I'm ready to take it on. And by the way, if you tuned in only to part of our podcast, because it started at the top, but maybe you skipped forward. And you see I'm naked here. Those of you on the YouTube show, you see I'm naked. No ring, no watches, all my devices.
30:25 Speaker 03 You're having a digital, not a total digital detox, because you still have your phone, but you're detoxing from your wearables for 24 hours. And what did you say when we went to the break after I took your devices?
30:37 Speaker 02 I said, I don't know if I can handle it.
30:39 Speaker 03 You said it in a very high pitched whiny voice. You did.
30:44 Speaker 02 You're so mean. You're so mean. Oh, well.
30:51 Speaker 03 Do my steps even count anymore?
30:53 Speaker 02 They don't count.
30:53 Speaker 03 Am I even walking?
30:55 Speaker 02 I'm not. Okay. Well, on that lighter note, thank you so much for joining us today on the podcast and the YouTube show. I hope that you heard something today, learned something today that's useful to you in your life. And know what we're about with everything we do is just that, that you gain ideas, you gain empowerment so that you can save more, spend less, and avoid getting ripped off. And have a great rest of your day.
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