Full Show: Clark’s “Scam Epidemic” Warning and Health Insurance Denied? Fight Back

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 gosh I hate starting off with something so negative so I'm going to make sure I'm even more negative later. 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. But 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 sink or buy whatever junk or con or ripoff they were selling. And 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 creating followings or befriending people and then scamming them. And some things are out and out scams. Others are more gray. So 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 that suddenly they do a wreck 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 finfluencers. Finfluencer is a what 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. 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. And this can be so many different things. 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 this is such a lucrative area. What I'm asking of you 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. And you end up before you know it with money of yours that ends up being money of theirs. All right speaking of scams Ray in Texas wrote him with this one, I want to make Clark aware of an active scam that's going on in Texas. Unfortunately I was a victim and this the real irony is I know to do my full research and I neglected to do so. I hope that Clark covers this and hears 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. The festival is $29.71? No $29.71. That's a cheap lesson from a scam if this is going to turn out to be a scam. 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. Ray thank you for this and 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 that you didn't 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 don't beat yourself up. There's a threshold above which whatever the point 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. 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. 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 and 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? I couldn't and I charge mine in my garage. 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 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 three quarters 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? The sale 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 power train in the United States because people get the idea of traveling for a 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. Okay a couple about your oral ring Clark. First Tom in Illinois wanted to tell you Clark loves the aura but check out this. The aura ring just got a new arrival with a titanium design and 24-7 biometric tracking with no subscription required and then here's the link there for you to check out this product. That's this one. Okay let me pull it up. Okay I'm looking. I see just a bunch of ads there Krista. It's the oh the Samsung gallery ring. There's actually a number of 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. It's the Acer FreeSense ring. That one I've not heard of but aura has created some vulnerability for itself by having monthly dues for the data and I'm grandfathered in because I've been an aura 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 aura competitors that don't charge the $60 I think $60 a year or $70 a year fee for data. Okay and then Nitty in North Carolina says Clark thought this would be a fun read addressing your aura ring craze. Read this on Kim Commando's newsletter destroying my mind that's how 22 year old Sarah Hills felt about her aura ring. Every spike in heart rate or dip in her readiness score sent her into a panic. It's called aura paranoia and she's not alone. Aura'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 phase you and give you an aura paranoia knowing that you are loaded with smart watches too and love that even if aura's own head of science takes a break from wearing it and we do joke like that like you're you could wake up feeling good but if your aura gives you a bad score you're like oh my gosh my day is I feel terrible. I have no idea when I wake up in the and I see my my aura rating if it's going to be good or bad it you know it comes up with data on how I sleep how 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 or paranoia 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 found that I'm competitive with myself anyway and the aura is like a game for me and it doesn't it I don't develop aura paranoia. I think you need a smart watch an aura detox like weekend where you just don't have any of it you don't worry about your ego sometime. There's this one. All right turn them in. This is the which one's this the Samsung? Samsung. Give me your Garmin. I've been Garmin longer than anything else. And your aura. There's my aura. All right. Okay here's my brain. You can go 24 hours. I'm not feeling any bad reaction to it at all. No I guess I guess that's true that uh that it would be helpful for me to detox from all the overload of data I look at every day. Oh my god you're getting dings on both of these watches right now. Wow. Really? This is very distracting. Really I don't even notice that they're dinging or anything. Okay we're gonna see if I can go we'll try and experiment we'll see if I can go 24 hours without any tracking at all. Okay. Maybe that's when I'll go crazy with no tracking devices. Clark goes dark. 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 get a lot sicker. What do you do? You spend a lot of money for health insurance or your employer is spending a lot of money for insurance. You only see part of that with the portion they bill you for it and then you got co-pays 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 one in six claims are now denied by health insurers? One in six. This is a game on their part and what happens with those one in six claims? Do you know that less than one percent of people do anything when a claim is denied? Less than one percent. Less than one out of a hundred people. You say oh well insurance doesn't want to pay so I'm just going to get sicker or I'm going to have this collection agency calling me about a bill. Don't roll over. Don't roll over. You know that if you appeal insurers know that 99 plus percent 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 so when you appeal depending on whose study you believe three out of four times or four out of five 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 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 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 eighty percent 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 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. 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. Whoa. 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. I felt totally cornered. My insurance only covered $500. What are my rights here and how can I fight or negotiate this outrageous bill? So 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 have the equivalent of their state system for no surprises on an ambulance charge and this is Illinois. I bet we can find a list. Well that didn't take long. Illinois does have protections for public and private ambulance services but it's only for people in HMO versions of insurance policies. What you do is 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 percent 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 and so if you get a big ambulance bill about two-thirds of Americans will be covered. The other third it's all about the negotiation that you do over the bill and and the hospital 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 have behaved that way. Okay Dan in Wisconsin says the continuing revelations about United Health'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? I find myself needing major medical care 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? 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 turn 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. So what you have to do is you got to know how to play pool better than they do and that's why you immediately exercise your rights to appeal under your plan period. I mean that's what's involved. 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 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. 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? Over a thousand dollars. Yeah do you have a thousand dollars just to say I 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 health care 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 and so 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 got to make this work. You know it's almost 20 percent of the U.S. economy now. Any other country the largest that health care spending is I think is eight and a half percent. Tim in Florida says 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 plans network. I was in the hospital for three days. Had this been an in-network my deductible would have been three thousand dollars which I actually paid while I was in the hospital. Since I was out of network my deductible is nine thousand dollars. So basically because I was taken to an out-of-network hospital I'm on the hook for the additional six thousand. This seems very unfair as I had to say 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 plan. I've been making very small monthly payments but not the 250 dollars a month the hospital is asking for. Now they are threatening to send my outstanding bill to collections. 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 were 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 and the reality is your insurer and the hospital are not on your side here because it seems that nobody has considered where 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. 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 up front so both of those I pay for up front. I file insurance and they claim the EOB's 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 and you're and so toward your high deductible you've paid $70 but really I've paid $170. So why do they do that for the same thing with my son's medical doctor they're like oh that should only be a hundred dollars so you've paid a hundred out of out of your deductible but really I've paid $250. What is that? Well because you went out of network your coverages are not nearly as generous. 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? I guess that's pretty much true. Okay anyway sorry this is my beef. Again health care in the United States is inefficient and 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. Yes. 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? No. Yeah so I'm ready to fix it. I knew how. I know really. I'm ready to take it on and by the way if you tuned in uh only to part of our podcast because sorry 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 no ring no watches all my devices. You're having a digital deep 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? I said I don't know if I can handle it. You said it in a very high-pitched whiny voice. You did. You're so mean. Oh well. Do my steps even count anymore? They don't. Am I even walking? 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 that you gain empowerment so that you can save more spend less and avoid getting ripped off and have a great rest of your day.