Short Answer

Yes. In North Carolina, your attorney can request the current lien amount and an itemized list of accident-related payments from your health plan or program, but they usually need your signed authorization. Private health plans often respond in 2–6 weeks; the North Carolina State Health Plan and Medicaid can take several weeks; Medicare often takes longer. Timelines vary by plan and workload, and your lawyer should request updates until a final figure is issued before any settlement funds are disbursed.

Understanding the Problem

You want to know if your North Carolina personal injury lawyer can get the health plan’s lien payoff and an itemized ledger of what the plan paid for your accident care, and how long that process usually takes. The key decision point is whether your lawyer, acting for you, can obtain and verify the plan’s reimbursement claim before settlement distribution. You used your health insurance for accident treatment, and you need clear numbers to resolve the case properly.

Apply the Law

Under North Carolina law, medical providers and certain payers can assert reimbursement rights against your injury recovery. Your lawyer may request and must protect valid liens before distributing settlement funds. The primary forum is the plan administrator (for private plans), the North Carolina Department of Health and Human Services for Medicaid, or the State Health Plan’s recovery vendor. There is no single statutory response deadline for all plan types, but liens must be resolved before your lawyer disburses funds.

Key Requirements

• Authorization: Your lawyer typically needs your signed HIPAA-compliant authorization or the plan’s specific release form to obtain claim details and itemizations.
• Notice of representation: The lawyer sends written notice to the plan/administrator (or NC DHHS for Medicaid) identifying the injury claim and requesting lien and payment ledgers.
• Itemization request: Ask for a detailed ledger limited to accident-related payments, with dates of service, providers, and amounts paid.
• Protect valid liens: Your lawyer must honor valid statutory or contractual reimbursement claims and resolve them before distributing settlement funds.
• Follow-up for accuracy: Review and challenge unrelated charges or errors; request updates until a final payoff is issued.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Health care provider liens) - Gives providers a lien on injury recoveries for reasonable charges.
• North Carolina Gen. Stat. § 135-48.37 (State Health Plan subrogation) - Authorizes the State Health Plan to recover amounts it paid from third-party recoveries.
• North Carolina Gen. Stat. § 108A-57 (Medicaid lien/subrogation) - Provides Medicaid’s lien and recovery rights against injury settlements.

Analysis

Apply the Rule to the Facts: With your authorization, your attorney can contact your health plan to obtain the lien amount and a line-by-line ledger of accident-related payments. The lawyer must review what the plan claims, remove unrelated charges, and negotiate as allowed. For Medicaid or the State Health Plan, your attorney contacts the designated recovery unit to obtain and confirm the payoff before releasing any settlement funds.

Process & Timing

1. Who files: Your attorney. Where: The health plan’s claims/recovery administrator; for NC Medicaid, the North Carolina Department of Health and Human Services (Third Party Recovery); for the State Health Plan, its subrogation vendor. What: Notice of representation, signed authorization, and a written request for lien amount and itemized accident-related payments. When: As early as possible after treatment begins and before any settlement distribution.
2. Plan response: Private plans commonly take 2–6 weeks to produce a ledger; NC Medicaid and the State Health Plan often take several weeks; timeframes vary by workload. Your lawyer should follow up every 2–3 weeks and request an updated or “final” figure when treatment ends or settlement is imminent.
3. Finalize and pay: After confirming accuracy and addressing disputes, your attorney obtains a final payoff, resolves the lien from settlement funds, and documents the payment and release in the closing file.

Exceptions & Pitfalls

• Plan type matters: Self-funded employer plans may assert contractual reimbursement governed by federal law; procedures and timelines can differ from insured plans.
• Unrelated charges: Itemizations can include non-accident care; ask the plan to remove unrelated entries or miscoded charges.
• Missing/expired authorization: Plans often will not release details without a current, signed authorization; some require their own forms.
• Multiple payers: If you have Medicaid secondary to private insurance, or separate medical payment benefits, each payer may have its own recovery claim that must be addressed.
• Premature disbursement: Do not distribute settlement funds until all known liens are finalized; unresolved liens can trigger collection against you.

Conclusion

In North Carolina, your attorney can obtain the health plan’s lien amount and an itemized ledger of accident-related payments with your authorization and must resolve valid liens before settlement funds are disbursed. Plan type drives the process and timeline: private plans often respond within weeks, while public programs can take longer. The next step is to have your lawyer send a signed authorization and written request to the plan or NC DHHS and follow up until a final payoff is issued.

Talk to a Personal Injury Attorney

If you’re dealing with health plan liens on an injury claim and need clear, accurate payoff and itemization, our firm has experienced attorneys who can help you understand your options and timelines. Reach out 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.