Can I negotiate with a provider whose bill isn’t secured by a lien?: North Carolina personal injury settlements
Can I negotiate with a provider whose bill isn’t secured by a lien? - North Carolina
Short Answer
Yes. In North Carolina, you can usually negotiate a medical bill that is not secured by a perfected lien or a statutory reimbursement right. Valid medical liens and statutory claims must be handled first and are subject to a cap under state law. An unsecured bill is a regular debt you may choose to pay or settle, but the provider can still pursue you directly if it remains unpaid.
Understanding the Problem
In North Carolina personal injury cases, the key question is: Can I negotiate a non-lien medical bill from my settlement? You are the injured person who has already settled, and funds are about to be disbursed. You want to know if you can reduce or negotiate a physical therapy bill that is not secured by a lien.
Apply the Law
North Carolina law gives certain healthcare providers a lien on a personal injury claim if they properly perfect it. A perfected lien attaches to the settlement and must be paid from settlement funds before the client receives the remainder, subject to a statutory cap. To perfect, an eligible provider must give proper notice and make records and itemized charges available as required by law. Bills without a perfected lien (and without a separate statutory reimbursement right, like Medicaid) are unsecured debts; they do not automatically get paid from the settlement and can be negotiated.
Key Requirements
Eligible provider and injury-related care: The charges must be for reasonable, necessary treatment of the injury tied to the settlement.
Perfection by notice and documentation: The provider must give written notice of the lien and furnish records and an itemized statement as required; without this, it is not a perfected lien.
Payment priority and cap: Perfected healthcare liens are paid from settlement funds before client disbursement, but total payments to all such liens cannot exceed a statutory percentage cap.
Unsecured bills are negotiable: If there is no perfected lien or statutory reimbursement right, the bill is a regular debt you may settle or pay outside the lien process.
Forum and handling: These issues are typically handled through the injured person’s attorney and trust account, not a court, unless there is a dispute.
Apply the Rule to the Facts: Here, two providers have liens, so those must be addressed first within the statutory cap. The physical therapy bill with no perfected lien is an unsecured debt; you may negotiate it, and it does not automatically come out of the settlement unless you authorize it. Because you prepaid the ambulance bill, reimbursement to you typically occurs after valid liens are resolved and before any unsecured provider is paid.
Process & Timing
Who files: The injured person, through their attorney. Where: Handled through the attorney’s trust account in North Carolina. What: Confirm which providers have perfected liens; obtain itemized statements; request lien releases from lienholders; for the non-lien provider, request a reduced payoff in writing. When: Do this before funds are disbursed so you preserve the ability to negotiate and properly honor any perfected liens.
Your attorney pays perfected liens first (subject to the cap), documents any reductions in writing, and holds any disputed amounts until resolved. For the non-lien bill, the attorney seeks a written agreement on a reduced balance or payment plan.
After agreements are finalized, the attorney issues payments to lienholders, reimburses you for the prepaid ambulance charge, handles any negotiated non-lien payment you approve, and disburses the remainder to you with a written settlement statement.
Exceptions & Pitfalls
Statutory reimbursement claims (e.g., Medicaid, Medicare, the State Health Plan) may apply even if a provider did not perfect a healthcare lien; these must be resolved from the settlement.
If a provider fails to furnish required records and an itemized bill, its lien may be unperfected; confirm compliance before paying as a lien.
Interest, late fees, or balance-billing can grow if you delay; negotiate promptly and get any reduction in writing.
Double-check coding and dates for duplicate or unrelated charges before negotiating; errors are common and can support a reduction.
Do not authorize payment of unsecured bills from trust funds until valid liens and statutory claims are resolved and written agreements are in place.
Conclusion
Yes. In North Carolina, only perfected healthcare liens and statutory reimbursement claims must be paid from your injury settlement, and lien payments are capped by law. A medical bill without a perfected lien is an unsecured debt you can negotiate. The next step is to have your attorney confirm whether the provider has properly perfected a lien; if not, request an itemized statement and negotiate a written reduction before the settlement funds are disbursed.
Talk to a Personal Injury Attorney
If you’re sorting out medical liens and unsecured bills after a settlement, our firm has 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.
