HealthBiz with David E. Williams

Automated medical bill audits for consumers. Interview with HealthLock CEO Scott Speranza

David E. Williams Season 1 Episode 183

Use Left/Right to seek, Home/End to jump to start or end. Hold shift to jump forward or backward.

0:00 | 31:21

Most medical bills contain errors. Over-billing and outright fraud are far too common. What's a consumer to do? 

In this episode,  CEO Scott Speranza shares how HealthLock performs automated audits of medical bills by seamlessly connecting with the patient's health plan portal. We also discuss an exciting new partnership with MasterCard that gives many cardholders (including me) free access.

I connected my insurance to HealthLock and soon got a helpful audit of my claims (which turned out to be clean --thanks Harvard Pilgrim!)

Scott unravels the complexities of coordination of benefits --where he offers reflection on my experience with my dependents--, the significance of automated HIPAA authorizations, and provides practical insights for managing family healthcare. And he shares his views on the delicate balance of privacy and oversight. 

One thing he recommends (which providers hate) is to wait for a while to pay your medical bills since charges initially attributed to the patient may actually be covered in the end.

As of March 2025 HealthBiz is part of CareTalk. Healthcare. Unfiltered and can be found at the following links: 

  • Spotify https://open.spotify.com/show/2GTYhbNnvDHriDp7Xo9s6Z
  • Apple https://podcasts.apple.com/us/podcast/caretalk-healthcare-unfiltered/id1532402352
  • YouTube https://www.youtube.com/@CareTalkPodcast
  • CareTalk website  https://www.caretalkpodcast.com/ 

Host David E. Williams is president of healthcare strategy consulting firm Health Business Group

Episodes through March 2025 were produced by Dafna Williams.

0:00:00 - David Williams
Healthcare bills can be incredibly complex and confusing. They're also usually filled with errors, over-billing and sometimes even fraud. Is there anything consumers can do to cope, except become medical billing experts and sleuths? Hi everyone, I'm David Williams, president of strategy consulting firm Health Business Group and host of the Health Biz Podcast, a weekly show where I interview top healthcare leaders about their lives and careers. My guest today is Scott Speranza. He is founder and CEO of HealthLock, which integrates with insurers to automatically audit medical bills, to provide consumers with savings and guard their privacy. If you like this show, please subscribe and leave a review. Scott Speranza, CEO of HealthLock. Welcome to the Health Biz Podcast. 

0:00:56 - Scott Speranza
Hello David, Nice to be here. 

0:00:58 - David Williams
You know I will say medical bills is a topic that no one really wants to talk about, but everybody kind of needs to talk about and they can't really ignore them, or you end up, you know, bankrupt or worse. So that's it. If you didn't have an ulcer beforehand, now you will. So anyway. 

0:01:13 - Scott Speranza
Yes, it's interesting. Most people know the pain of medical bills, understand it's a nightmare when you call, and yet of course we have to pay them and in the end it almost sometimes feels like you're leveraged to pay them because if you don't, your credit goes and you got debt and so forth. 

0:01:29 - David Williams
So yeah, it's not pleasant, all right. So let's let's start way back and I want to ask you a little bit about your childhood. You know what was your childhood like? Any, any childhood influences that have stuck with you throughout your career. 

0:01:43 - Scott Speranza
You know, I guess going back would be my father actually. So my father was. You know your prototypical story of an immigrant family grew up very poor in New Jersey, you know, wrong side of the tracks and was really a self-made man, sold a company, built a company to about 5,000 employees and I was a part of that, from sweeping warehouses to working in accounts payables in high school. But he was really a role model of work ethic, certainly perseverance and then having a nice exit. So I was privileged to be able to see him and interact with him and he's still alive and kicking. So he certainly helps even today with lots of good wisdom. 

0:02:29 - David Williams
That's outstanding. And what did you do for school besides this school of heart knocks? 

0:02:34 - Scott Speranza
Well, I went to the University of Arizona my first two years, you know, thought I was going to be a great baseball player and so I wasn't, yeah. And then ended up transferring to a liberal arts college called Westmont College up in Santa Barbara, which was just fantastic, got this big school experience at Arizona, small school for business and business economics and most of my college friends actually are still today, or from my college days at Westmont. 

0:03:01 - David Williams
Okay, cool. Well, I saw that you know in terms of early career, at least from what I could pick up, you did a lot of these so-called TLA. You know three-letter acronyms RSA, pwc, sap, ibm so give me your career path there from after the baseball. 

0:03:16 - Scott Speranza
I didn't see MLB in there, I guess no no MLB clients but no, so you know I actually. So my, my dad was in contracting services and so you know I had some background there and office background and so forth, but really had no tech experience. And so I fought hard to get an interview at a company called RSA Security. This is where you know you have your token and two factor authentication and fortunately they took a risk on me and that started and launched my career in tech, leveraged that into PricewaterhouseCoopers where I was able to help companies Fortune 100 companies with their management services and big ERP implementation. So now learning big tech. And then really dialed in with a company called Business Objects, which SAP then bought, which is in data analytics. Company called Business Objects, which SAP then bought, which is in data analytics. So really understanding now the power of data, not just the internet but really what you can do with data, from logistics to financial, to procurement, vendor management. 

And then I had a very good opportunity to run sales at a company called actually FiberLink Moth 360, again on the security side for big companies. That was actually bought by IBM, created a nice little exit for me, which was wonderful, and I launched that to start use that to help launch a company called Inassist, which is the precursor to HealthOc. So think of it as, and still exists today. So Inassist, think of it as your high-end premium. You know actors, directors, producers, billionaires needing global concierge medical assistance and then HealthFock being for. You know folks like us and everybody else that wants something more automated, a little cheaper, on the price point right. They don't necessarily need that concierge global assistance and that's the HealthFock brand. So both brands are in play today in assist for the high net worth folks and HealthOck for the general community. 

0:05:13 - David Williams
Sounds good. Well, there's like a line there because somebody could be high net worth until they have to pay their bill for surgery or something like that. They could take them down into the regular Joe category pretty quickly. 

0:05:23 - Scott Speranza
No doubt we just actually saved a very high net worth person that people would know about two $300,000 on their bills, got them back money they paid out. Yeah, we got chocolates and flowers and cards and they just loved us. And you know, even the most wealthy certainly want to have a fair transaction. Yeah, and that's what we do, that's what we provide. 

0:05:45 - David Williams
You know, you mentioned, you know, medical bills. You got to pay them and I mean I think, yes, in general you have to pay the legitimate ones and to pay the right amount. I mean, I sometimes see, one of the things that sometimes strikes me is you'll see someone doing a fundraiser for you know, to pay the medical bills of somebody. And I'll see, you know, somebody you know went in and they ended up running up a bill of $100,000 for whatever. They didn't have the right insurance, out of network, whatever. And my first thought is sometimes to say, well, rather than raising $100,000 to pay that bill or whatever, maybe, maybe you should go and tell them, like I'm not paying it, like that's not a reasonable amount. Forget it, you ever get. What is your thought on that? 

0:06:28 - Scott Speranza
Well, there's actually even a book out that says don't wait to pay your medical bills. And so, because it's so complex and 20% of Americans are going to receive a denied benefit this year, of that, only 1% are going to appeal that why? Because it's complex and it takes time and effort and knowledge of the industry, and so the most smartest folks, conventional wisdom right now, is well, just wait to pay your bill, and if you go 60, 90, 120 days, something good might happen where more gets paid or they'll negotiate with you and you'll save some money. And, as you know, more than half of all credit issues are medical related, billing issues related. Sixty six percent of bankruptcies, of course, are due to medical bills, and there just really isn't a third party that can assist. 

Whether you're a consumer or an employee, we see that you're the same person. There's no one to tell you that was a fair transaction. There's no one looking on your side to say pay that bill with confidence that was adjudicated correctly or that was overcharged by two, three, 400%, that's a balance bill that actually you don't owe. That's an upcharge. Or a duplicate service that technically is an error. Three, 400% that's a balance bill that actually you don't owe, that's an upcharge or a duplicate service, that technically is an error, mistake or fraud, and we catch that for you automatically with our platform. So there really isn't anybody out there doing what we do to say pay it when it's good to pay and then let's challenge it and go see if we can save money. The conventional wisdom is just wait to pay your bills, or you know what. I just got to pay it because I don't have the time, energy or expertise. 

0:08:02 - David Williams
Yeah, it makes sense. All right, so I get it In assist. You're dealing with, you know, high net worth people. You're dealing with big claims. It's worth their effort. You know something doesn't really matter it's if it's big enough you know it's worth it to deal with it. But a lot of these things are sort of the small and medium area and, as you say, you know, for the regular, regular folks. So you talk about this platform. So what? What is the platform? How does it? You know how? How does it work? 

0:08:27 - Scott Speranza
Well, so again going back to my days, you know from the business objects, sap, data analytics. You know the challenge was can we create software? Uh, very similar, you know, and we're talking about Inassist, healthlock, but HealthLock, lifelock, right? So LifeLock, a lot of DNA here from that. Lifelock automatically looked at your financial transactions to identify fraud and or identity theft, and so we wanted to develop a platform that could do the same thing automatically. 

So there's, you know, millions of people that maybe don't even know from their employer. They have something called advocacy and advocacy is an 800 number that you basically you know. Hey, if I remember I have it, I take a picture of my bill, I send it over to them and they might help me give me guidance or advice and maybe, if you're lucky, they'll help you actually adjudicate and lower, you know, save some money. But that's not, that's a manual process, that's not a process that we think is scalable, valuable and certainly is limited. One percent of companies, employees, use that kind of service. So we really turned it upside down and said, ok, let's be like a life lock, where we're automatically, without user intervention, analyzing in every single health care transaction, whether it's medical, dental, vision, Rx, and then we're going to tell you automatically good to pay. So you get a message, a text or an email that says hey, that $700 bill paid in confidence. It was adjudicated correctly against your insurance, it was the right price, it wasn't fraudulent. Pay it with confidence. That peace of mind is valuable and people love that. 

And then, of course, we flag bills that look suspicious. A code's not right, there's a code missing, it was a denied benefit, it looks like a balance bill and then we resolve that and this is the platform that we've built. Now close to well over half a billion dollars of claims have now been funneled through the system. This isn't a company with $100 million of claims being downloaded. These are individuals that have used our system and platform to go ahead now and have us analyze, audit and resolve their issues, where we've also now returned close to over $130 million. We're approaching $200 million return to our customers in savings. That's the platform data analytics, security, protecting your privacy, giving you access to all of your bills. There's a control feature showing your deductible with deductible tracker. Really, one place to say everything I need to pay my bills confidently is there with HealthLock. 

0:10:57 - David Williams
Got it. Now. How do the? I know that you integrate with the health insurers because I actually logged in. Actually, you have a deal with MasterCard, it appears, and I was able to go through MasterCard and log into my Harvard Pilgrimage, which is where I have my insurance, and you're going to automatically download and analyze the claims. How does a health insurer look at you? Is it just like somebody bothering them, standing over their shoulder? Are you helping them? Or you know what's the relationship like? Or you know why don't they just do it themselves? 

0:11:25 - Scott Speranza
Well, that's it. You know, again, this is a complex problem with a complex answer, and I'll try to make it as simple as possible, right? So most people believe that the carrier is looking out for me. Right, I have UHC. My carrier obviously is negotiating these contracts and these prices, and so isn't the carrier taking care of all this. 

Well, it's a big industry. It's a four or five trillion, six trillion dollar industry. Now, right? And so what we kind of say is you know, carriers may have a one, two, three percent error rate. That's not accurate, though. It's much higher than that, because they auto adjudicate the lower level claims. And, of course, then you've got out of network claims, denied benefits that are over and above that. So I kind of feel like we catch the pennies in the dollars of the world. But that adds up to three hundred and fifty billion dollars. That's not our statistic. That's third party overcharges and fraud is 350 billion dollars of loss, and that's in our out of pocket expenses. So there's about 500 to 600 billion dollars of out of pocket outside of premiums, copays, deductibles, out of network charges, labs and so forth that we pay as consumers, americans, and that's the number we're focused on to reduce for your out-of-pocket expenses. 

So the carriers have a very interesting relationship with one. They can't look at billions of transactions at a certain level we do. They also. You know 20 percent of Americans are going to get a denied claim. Who's denying those claims? The carriers. So if you call the carrier to fight a denied claim, you're calling the fox watching the hen house and saying, hey, can you please pay my claim? And they say, no, that's, we're the ones that denied it and that's why only one percent of folks really challenge it and then two out of three of those folks don't have a successful outcome outcome. 

So we work with carriers, we work with providers. I'd say about 50 to 60% of what we resolve is what we call kind of clearing the pipes. There's codes missing, there's x-rays that aren't there, there's a price point there that was a mistake or error, and so we add data that's needed to kind of clear that so that our customers get the right pricing. But about 30 to 40% of that is hard negotiations. Why was that MRI $1,500 when down the street it was $500? That's price gouging. Why do you continuously? 

You know we had twins and my wife and I would go in and we'd have a sonogram every six weeks. Then, sure enough, it was $800. Our insurance would pay $400 and we'd get a balance bill for $400. We'd be like, well, I guess we owe it. Thankfully HealthOc was like no, you don't, that's a balance bill that actually is over and above the contract rate. 

Healthoc would call and they'd say, oh, we're so sorry, that was a mistake, and they'd credit it. Well, six weeks later we go back to the sonogram and the exact same thing would happen. Is that fraud or is that just errors? And so the carriers just can't get to that level of oversight. And then the last thing on the carrier side I'll say is this is that the carrier value is really two things price and then my provider network, are my doctors in my network? So if the carrier is too hard with the system or with doctors, the doctors can just say I don't want to work with you anymore and the value to the carrier's network goes down, making them less competitive. So there's really this. We call it this, don't ask, don't tell relationship between carriers and providers, because it's just the small out of pocket stuff $350 billion worth. 

0:15:07 - David Williams
Yeah, yeah, yeah, yeah, the big pocket. So you know, so a lot of things in the is. A tremendous amount of money is just spent on the administration of healthcare benefits in the US and there's a lot of friction and it sounds like in some places you want to get rid of that needless friction. Like, as I said, it was real easy for me just to put in. I just had to put in like the first few digits of my MasterCard, I think, which is probably just to demonstrate whether it was for, whether my bank covered it To get your discount. 

0:15:34 - Scott Speranza
So let me so sorry, david, throw in. 

So, MasterCard fantastic partner. Right, obviously, their global reach. We've been now. Our press release came out, a couple you know, two weeks ago. We've been now approved for all 60 million you know MasterCards in the US to have our HealthFox service, so we'll protect you from fraud and we'll verify your bills as a MasterCard customer. If you want us to resolve something, then you go ahead and you get into a membership. So that code that you put in for MasterCard was to be eligible for that discount Got it and MasterCard has been a fantastic partner. They spent about a year vetting us our security, our scalability, our proof. We saved MasterCard employees a ton of money and so they've been a fantastic partner. That's the MasterCard relationship. 

0:16:23 - David Williams
Got it All right. Well, as long as we're talking about that. So you said you saved their employees money. I was trying to understand, like, what's in it for them, like why would they want to be part of this? 

0:16:30 - Scott Speranza
Well. So MasterCard, of course, has relationships with every issuer, from a Capital One and Citibank to credit unions, and they're using their MasterCards and so they come out and offer those issuers Capital One would be an issuer benefits on the card, extra benefits to say, "'hey, it now does points for travel. I can buy different services like Uber' HealthFock is now one of those services benefits that an issuer can add to their card for their users and members to get value and there really isn't much in healthcare. It's been a puzzle that MasterCard and others have been trying to solve because it's so complex. And they saw HealthLock and said that is a service that we understand. They understand fraud and so we're part of the fraud unit within MasterCard, and the added value benefit of checking pricing is just well beyond what anybody else is doing. So MasterCard has been a fantastic partner for us Got it. 

0:17:35 - David Williams
Okay, so I put that in, so that's good to know, that's why I got my discount. And then I so I put that in, so that's good to know, that's why I got my discount. And then I signed into my health plan the same way I normally would, and now you're doing the process of analyzing my claims and so on, so you're taking the friction away from kind of getting the data and analyzing it, but then presumably you're going to put some friction back in if we see that, hey, you guys are overcharging me, or. But you know, or something like that Is that. Is that the way to think about it? It? 

0:17:58 - Scott Speranza
is. So what you did we call syncing right. So we're syncing our platform with the carrier platform, which is against a UHC being the biggest Now we're synced. So now when you're getting a claim adjudicated, we're automatically getting that. You don't have to send us anything. You don't have to remember that we exist. A lot of our members just forget about it and all of a sudden, six, seven months later, they get a hey, you had a claim, this was the doctor, this was the amount and that $400 is verified. Pay it with confidence or, of course, a flag. There's something wrong and we could potentially save you money. So that's our syncing process. 

So now that we're synced, we're there to now look at we monitor 24-7 all your doctors for HIPAA violations, data breaches as you know, uhc and Change Healthcare obviously were in the news lately with significant issues. Pre-covid, there was a few million data breaches and patient records that were breached. Last year there was 171 million patient breaches. The year prior was 57 million, I believe. The year prior to that was about 30 million. So you've seen this incredible increase of breaches because your healthcare data is worth 40 times more to the black market organized crime than even your social security number, which, back in the day, was like a thing. The thieves have really moved over to health care and it's really taken us by storm and there's a lot of damage that's happening and a lot of dollars being lost. 

So we 24-7 monitor your doctors, tell you if there's been a breach, a HIPAA violation, and we're now looking to help remediate, restore medical records, credit issues that potentially have happened. You might have a bill show up on your credit report. You have no idea how that got there, because it was medical identity theft. And then, of course, we're doing things like deductible tracking and just ensuring that one place has all your bills. So we call this the sandwich generation, right? So you've got yourself, your parents and your kids you're taking care of. Well, all of your bills are in one place, so you don't have to go to each provider or the carrier to see that. You can just go to your health portal. 

0:20:08 - David Williams
You mentioned the MRI example and saying hey, you're price gouging and so on, but who do you say that to and what do they say other than you know we'll go down the street next time. Can you actually effectively negotiate these things and is it worth it for $1,500? 

0:20:26 - Scott Speranza
You can. And again, it's all in the data, right? So if you then call somebody as a consumer and say, hey, I just think this MRI is too expensive. You know, $1,500 seems like a lot of money? Well, the standard answer is going to be well, that's your rate. You know $1,500 seems like a lot of money? Well, the standard answer is going to be well, that's your rate, that's the negotiated rate, that's what your insurance carrier has, or that's just who we are, because we're such high quality. There isn't really a good story there. 

But if we can say, hey, we have national data, regional data and the five that are down the street, you're 300%, You're two, three times higher than them, we see this as price gouging, we them. We see this as price gouging. We see this as something that is unnecessary, as you've seen from even the legislative body, the no Surprise Bill Act. Transparency is the name for the carriers and providers today, and so when we say things like this is really butting up to what is being protected now from a legislation standpoint. You can't just charge these kinds of prices. 90% of the time, we're successful in price gouging to lower that, even if it's a 10% reduction, but often it's much higher than that. 

You got to have the data, just like in the appeals process. It's not that we're just like please pay us, because we're good people. We're going through like a lawyer submitting a case and saying these are the precedents and this is the issue that happened and this is why we got denied. And you're only denying us because you deny the first three appeals. It seems like right. So those it's all in the data, David, that's where we find our secrets off, Got it? 

0:21:54 - David Williams
Let me mention a couple of things that always give me a hard time and see if there's anything that can be done about this. So one is that I have dependents on my health insurance that are adults and I don't have access to their medical record, so I can't see the claims, but somehow I'm still responsible for paying the bill. So one question is about. This is the easy question. So one question is like how do we deal with that? Like, if I've signed in, am I gonna be able to deal with their bills? And the second one is a harder one, which is a coordination of benefits. 

I have one uh, you know kid that was off in college and and and they had both insurance in Boston, where I live, and in school, where they, where they were and you had the wrong thing gets charged. And then, uh, nothing happens. And then by the time it's done, you say well, they should have charged the other one. Then they say, well, too late to file a claim. How do you deal with these? I think these are typical issues and I don't know how to deal with them. 

0:22:49 - Scott Speranza
Well, I heard six questions there. So the first thing is that we make it easy. So it's a family oriented plan, so your whole family, that's in your benefit. So you're again with UHC and you've got your spouse and your children are in that plan where they're up to 26 or down. We have a whole automated HIPAA authorization process. So if it's a carrier that says, okay, one HIPAA for all, then all are in your platform, in your portal. If it says, well, one for you as the primary, but you have to get HIPAA authorization from your kids or your spouse, the system does that for you so they can just sign it automatically. They're done and then all those claims get added so you can see your whole family. If you're even outside let's say, your spouse is on their work plan, not on your plan with Anthem you can attach them and also be within your portal as your family member. So that's convenience and that's something that we've set up for convenience. The other question as far as coordination of benefits, give me some more on what that question was, please. 

0:23:57 - David Williams
So the question is, let's say so, I have a student who is out of state for school but gets care in Boston, and so they. I assume that we'd use the insurance that's based in Boston instead of something that's from another state but then turns out well, that's considered. 

our coverage is secondary, even though that's the out of state one, that's first, and so the hospital billed the wrong one by the time we went through all this stuff waiting to pay and what's what, and then it submitted it to the original one that should have had it. They're like well, the claim is too old now we won't take it. 

0:24:34 - Scott Speranza
Oh, it's too old stuff, right? Yeah, yeah, so this is actually part of you know, really, the high net worth like actors, directors, right? So they're a director, producer. That's three different insurances. 

0:24:47 - David Williams
Yeah, who wants? 

0:24:47 - Scott Speranza
to be the primary, who wants to be secondary or tertiary. So we have great experience with fighting these things. So in your son's case, yeah, we'll go ahead and make sure that they've got. You know, our system has what we call a case management for you. Okay, so you actually can see all of your claims, you can see where it is in the process of this investigation and then also, too, you're going to have the ability to. Through us, we'll set up and fight who was primary, who was secondary, who was tertiary. We do tertiary. We'll do all that for you. Yeah, and this whole lie about being too old, we've gone back two, three, four years. Certainly, the carriers all have a different level of one year, two years, three years, but if it's egregious, we've gone back four years and recovered money from folks. 

So, don't, don't worry about necessarily the carrier's policies. We just want to be able to present to them the facts and the data, and normally then those things have a high percentage of success. 

0:25:49 - David Williams
You know, the way I dealt with this particular issue was that I happened to know the CEO of the hospital and of the insurance company and, after a path where they were trying to collect $ hundred thousand dollars from me for three infusions, you know, I just wrote to both of them and they they replied very quickly and dealt with it. But that's not the average person. It's not going to deal with that. 

0:26:08 - Scott Speranza
For sure You're an expert right what to say, how to say it, and then take the time to do it. 

0:26:14 - David Williams
Yeah, but still, I would rather have you do it, because I would rather be talking to these guys about selling new consulting projects, not, hey, you know, can you deal with my one particular Well, a valuable commodity is time. 

0:26:23 - Scott Speranza
There's no doubt. Yeah, a lot of our folks signed up for that control piece right, so I don't have to deal with it. Yeah, save me money, that's fine, but I really love the fact that I don't have to deal with it. 

0:26:34 - David Williams
So you mentioned you know privacy issues and you know monitoring for data breaches and HIPAA violations and so on. Inherently, if you're adding an additional, you know if you're an additional party there, that adds, I would guess, some risk in case you were to get breached. So it's sort of the idea that I'm going to have somebody else come in to watch in case a breach occurs. There's something a little counterintuitive about that. 

0:27:00 - Scott Speranza
Well, the first thing is that you know PHI is a broad term but there's levels of PHI, right? So if I'm a doctor and I have your medical records and your x-rays and all those things and I get breached, your patient record could include all those things. Our system in that download, in this syncing as we talked about, is level one. So it's code numbers, it's name, it's things that don't necessarily have these deep, more risk-associated type of datas like your x-rays and your test results and those kind of things. So we have a level of protection just because of the type of data that we get. 

But sure, everybody is vulnerable. There isn't a company out there that's not vulnerable. The other thing is there's about an average of about seven people that on any visit to the doctor see your medical data, and so it's not that you don't necessarily have certain experts that you want to see and touch it. That's going to happen. You just don't want it to get to the thieves and used nefariously, and then, if it does, you just want somebody that can clean that up, take that off the dark web, take that off your medical record, take it off your credit report, and that's what HealthLock does we notify and then resolve those issues for you. 

0:28:22 - David Williams
Got it All right. That makes sense. I love this. There's also, you know, there's these scams related to people not you, but that are saying that they're going to help to resolve things. My favorite one was I got one of these robocalls and it said it was from the IRS and they said they're going to cancel my social security number. I'm like go for it. 

0:28:38 - Scott Speranza
You know, I don't think that can be done but it sounds like other messes can be can be cleaned up fairly readily. It can, and again, it might not be until you go to service and you get a. You get a denied benefit Right and then the denied benefit in our investigation turns out to be because there was a fraudulent claim on your benefit and so it naturally just adjudicated it automatically and it denied it. We can resolve those things. So you know, it's not impossible, it's complex. You certainly have to have the systems, the people, the expertise. But the other thing is is that it's just more prevalent now. 

It is literally something that's going to affect most Americans at some point over the next five years. The other thing is no one plans. You know, unless you have a chronic issue, no one plans for your care. I'm healthy, it's OK, and then the next day I might get an accident or might break my leg or I've got to go in for my physical and they find something. So you've got to plan and you certainly want to be more proactive with your health care and hopefully, in our case, somebody that's looking out for you automatically. 

0:29:45 - David Williams
Scott, my last question for you is whether you have read any good books lately, anything that you would recommend, or, conversely, you know, if you read a bad book and you think we should not waste the time, tell us about that too. 

0:29:55 - Scott Speranza
Well, you know, interesting. So I read a lot of, you know, books just about the human condition and so forth. So I love John Eldredge and Wild at Heart. I'll read, you know, every once in a while and I just pick that back up. But actually I was talking to Todd Davis, the ex-CEO of LifeLock. He was the founder and he recommended a book called Blitzscaling by Hoffman and so I've picked that up and began reading that and it's how to literally take a company from zero to hero and all the challenges that come with that. As HealthOc is becoming a national brand. You know, certainly we have those challenges and I absolutely love the book. It's phenomenal. That's probably the most recent book that makes good sense to me. But boy, bad books. I don't like bad books. So I'll put it down after that first page. 

0:30:43 - David Williams
I'm done Sounds good. Well, Scott Speranza, founder and CEO of HealthLock, thanks for joining me today on the Health Biz Podcast. Thank you, David. You've been listening to the Health Biz Podcast with me, David Williams, president of Health Business Group. I conduct in-depth interviews with leaders in healthcare, business and policy. If you like what you hear, go ahead and subscribe on your favorite service. While you're at it, go ahead and subscribe on your second and third favorite services as well. There's more good stuff to come and you won't want to miss an episode. If your organization is seeking strategy consulting services in healthcare, check out our website, healthbusinessgroupcom. 

Podcasts we love

Check out these other fine podcasts recommended by us, not an algorithm.

CareTalk: Healthcare. Unfiltered. Artwork

CareTalk: Healthcare. Unfiltered.

CareTalk: Healthcare. Unfiltered.