Short Answer

In North Carolina, you gather HIPAA-compliant authorizations, request the provider’s itemized bills and treatment records, and verify any healthcare liens before disbursing settlement funds. Medical providers may claim a statutory lien on personal injury recoveries, but total medical liens are capped at 50% of the net recovery after attorney’s fees. Resolve Medicare/Medicaid and insurer reimbursement claims and obtain a final payoff letter and lien release before closing.

Understanding the Problem

In North Carolina, how do I, as the injured person’s attorney, get the medical records, confirm authorization to release them, and verify the rehabilitation provider’s lien so I can finalize a personal injury settlement? One key fact: there is one open therapy lien account with a remaining balance in the case file.

Apply the Law

North Carolina law allows medical providers who treated accident injuries to claim a lien on the settlement, but it limits how much of the client’s recovery can go to those liens. Providers must furnish itemized statements and records upon request so the lien amount can be verified. If public benefits paid medical charges, those programs have separate recovery rights that must be resolved before disbursement. The work happens outside of court; the attorney coordinates with providers and payers and then disburses from the trust account. A key threshold is the 50% cap on medical provider liens after attorney’s fees are deducted from the settlement.

Key Requirements

• Valid authorizations: Obtain HIPAA-compliant releases to request treatment records and billing from each provider.
• Itemized statements and records: Request detailed billing and necessary records to verify injury-related charges and balances.
• Lien verification: Confirm whether the provider asserted a North Carolina medical lien and the exact payoff.
• Third-party recoveries: Identify and resolve Medicare, Medicaid, and any health plan reimbursement/subrogation claims.
• Distribution cap and releases: Apply the 50% cap on medical provider liens after fees; obtain final payoff letters and releases before disbursement.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider lien) - Allows providers to claim a lien and requires furnishing records and itemized statements upon request to support it.
• North Carolina Gen. Stat. § 44-50 (Distribution of recovery) - Sets lien payment order and caps medical provider liens at 50% of the recovery remaining after attorney’s fees.
• North Carolina Gen. Stat. § 90-411 (Medical record copy fees) - Governs permissible charges for copies of medical records.
• North Carolina Gen. Stat. § 108A-57 (Medicaid lien) - Provides the State’s lien for Medicaid-paid medical expenses on third-party recoveries.

Analysis

Apply the Rule to the Facts: Here, you need HIPAA-compliant releases to request the rehabilitation provider’s itemized therapy bills and related records. Verify whether the provider asserted a lien, confirm the current payoff on the single open account, and ensure charges are injury-related. Then identify any Medicare/Medicaid or health plan reimbursements and resolve them. Finally, apply the 50% cap on medical provider liens after attorney’s fees, obtain a final payoff letter and a lien release, and disburse.

Process & Timing

1. Who files: Plaintiff’s attorney. Where: Provider’s medical records and billing departments; Medicare/Medicaid/insurer recovery units. What: HIPAA-compliant authorization(s), written request for itemized statement and records, and a written lien verification/payoff request. When: Start 30–45 days before the anticipated settlement to allow response time and payoff verification.
2. Reconcile all balances: match itemized charges to treatment dates, remove unrelated or adjusted items, and confirm any insurance, Medicare, or Medicaid payments. Request “final lien/payoff” letters from each provider and from Medicaid and health plans; obtain Medicare’s final demand (procedures and timelines can change; many require prompt payment to avoid interest).
3. Disburse and close: apply the statutory order and 50% cap, pay finalized lien amounts from trust, secure written lien releases, and issue the client’s net proceeds with a closing statement.

Exceptions & Pitfalls

• If a provider does not furnish itemized statements/records to support its lien when requested, lien rights can be affected; document requests and follow up in writing.
• Medicare and Medicaid recoveries are separate from provider liens; resolve them even if the 50% lien cap would otherwise be met.
• Self-funded ERISA health plans may assert reimbursement rights that are not governed by state lien caps; evaluate plan language and negotiate accordingly.
• Ask for “final” payoff letters close to disbursement to avoid surprise add-ons; confirm that balances reflect contractual write-offs and payments.

Talk to a Personal Injury Attorney

If you're dealing with medical records, liens, and reimbursement claims while closing a PI settlement, our firm has experienced attorneys who can help you understand your options and timelines. Call us today at 919-341-7055.

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.