I do not think this is an advance fee scam. I think the pay-per-call commenter is closest.

Here's what I think is happening. A marketing firm has told some local businesses that it will do online marketing and other marketing activities to drive leads in the form of calls to the business. The marketing campaigns will focus on specific issues (like insurance coverage for weight loss).

It's not atypical for a marketing agency or demand generation company to guarantee a certain number of leads per campaign -- eg, if you spend $1,000 with us, we will guarantee you get 50 leads.

I think a call-based / real-world demand generation agency is stuffing the leads for their customers because the actual campaigns aren't delivering.