Short Answer

In North Carolina, send the hospital or provider a written request that includes the patient’s full name, date of birth, dates of service, and your letter of representation. Include a HIPAA-compliant authorization signed by the patient. If the provider is asserting a lien related to a personal injury claim, North Carolina law requires it to give you one free itemized statement and related records to verify the lien, and liens are subject to a statutory 50% cap after attorney’s fees.

Understanding the Problem

In North Carolina personal injury matters, a law firm wants an updated medical lien balance from a hospital. The question is: what must the firm provide so the hospital can lawfully release current lien details and an itemized statement?

Apply the Law

North Carolina law recognizes medical provider liens on personal injury recoveries. A provider that asserts a lien must, upon request, furnish an itemized statement and related records to verify the lien. Attorneys must honor valid medical liens from settlement or judgment proceeds, but total payments to providers are limited by a statutory cap after attorney’s fees. The request is made to the provider (not the court) and should be made before disbursing settlement funds.

Key Requirements

• Patient identifiers: Provide the patient’s full name, date of birth, and dates of service; include account or medical record numbers if known.
• Authorization to release: Include a HIPAA-compliant authorization signed by the patient (or legal representative) and your letter of representation.
• Scope: Specify the incident and injury-related treatment so the provider limits the itemization to lien-eligible charges.
• Itemized statement request: Ask for the current lien balance and an itemized bill; a provider asserting a lien must supply one copy without charge upon request.
• Settlement coordination: Note any pending settlement timelines so the provider prioritizes the update; liens must be resolved before disbursement and are subject to a 50% cap after attorney’s fees.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider liens) - Creates provider liens and requires furnishing one set of records/itemized bills to verify the lien upon request.
• North Carolina Gen. Stat. § 44-50 (Enforcement and cap) - Sets priority after attorney’s fees and limits total lien payments to 50% of recovery after attorney’s fees.
• North Carolina Gen. Stat. § 108A-57 (Medicaid liens) - Addresses Medicaid’s rights; handled separately from provider liens.
• North Carolina Gen. Stat. § 135-48.37 (State Health Plan subrogation) - State Health Plan recovery rules; not subject to the typical provider-lien cap.

Analysis

Apply the Rule to the Facts: Because the request comes from a law firm to a North Carolina hospital for a client’s personal injury treatment, include the client’s identifiers and a signed HIPAA authorization with a letter of representation. Request a current lien balance and itemized bill limited to injury-related services. The hospital, if asserting a lien, must provide one set of records to verify the lien. The firm should be prepared to resolve the lien from settlement funds subject to the statutory 50% cap after attorney’s fees.

Process & Timing

1. Who files: Plaintiff’s attorney. Where: Hospital billing/lien or patient financial services office in North Carolina. What: Written request with patient name, DOB, dates of service, incident description, account/MRN (if known), signed HIPAA authorization, and letter of representation; ask for an itemized bill and current lien balance. When: Early in the case and again before settlement disbursement.
2. The provider locates the account and issues an itemized statement and current lien balance; response times vary by facility, so allow reasonable processing time and follow up.
3. Attorney confirms injury-related charges, addresses any reductions, then pays the lien from settlement per statute and obtains a lien release or zero-balance confirmation.

Exceptions & Pitfalls

• No HIPAA authorization: Without proper authorization, providers may decline to release balances and itemizations.
• Multiple providers: Hospitals, EMS, imaging groups, and specialists may each assert separate liens; request each one’s itemized statement.
• Cap and priority: Total provider payments are limited to 50% of recovery after attorney’s fees; coordinate pro rata if funds are short.
• Public benefit recoveries: Medicaid and the State Health Plan follow separate rules; Medicare has federal recovery rights. Handle these in addition to provider liens.
• Wrongful death differs: Wrongful death distributions have additional statutory limits and allocation rules that do not apply in the same way to living-plaintiff personal injury liens.

Talk to a Personal Injury Attorney

If you need an updated medical lien balance for a North Carolina injury claim, our firm can help you request the right documents and navigate the lien cap rules. Call us today.

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.