Short Answer

In North Carolina, send a written payoff request to the provider’s patient accounts or lien department with your client’s identifiers and a signed HIPAA authorization. Medical providers must furnish an itemized statement upon request at no charge, and any perfected medical charges are paid from settlement funds with priority rules that protect attorney fees and require pro rata sharing among providers. Obtain a written payoff good-through date and a lien release before disbursing funds.

Understanding the Problem

You’re a North Carolina personal injury attorney trying to clear one unreimbursed physical therapy charge. You need to know how to ask the billing service for a precise payoff so you can pay the correct balance at settlement and get a release. The decision point is: how do you, as counsel, request and document a final payoff to resolve that specific outstanding therapy date?

Apply the Law

North Carolina law gives medical providers a lien against personal injury recoveries for reasonable charges related to the injury. To evaluate and resolve those charges, you may request an itemized statement and a current balance; providers must supply that information on request. When settlement funds arrive, the attorney holding the funds is responsible for satisfying perfected medical charges from the proceeds, after attorney’s fees, with providers sharing proportionally if money is short and subject to statutory caps.

Key Requirements

• Written request with identifiers: Include patient name, date of birth, dates of service, account numbers, and claim number if applicable.
• HIPAA authorization: Attach a current, signed HIPAA-compliant authorization so the billing service can release itemized statements and balances.
• Itemized statement: Ask for an itemized ledger of all injury-related charges, payments, adjustments, and the current payoff good through a specified date; providers must furnish an itemized statement upon request without charge.
• Attorney handling of liens: At disbursement, satisfy perfected provider liens from settlement funds after attorney’s fees; providers share pro rata if funds are insufficient.
• Cap on provider recovery: The aggregate paid to medical providers from the settlement is limited by statute relative to the recovery after attorney’s fees.
• Written release: Obtain a written lien/balance release confirming a $0 balance for the injury-related dates once payment clears.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider lien) - Providers have a lien on injury recoveries for reasonable charges and must provide an itemized statement on request.
• North Carolina Gen. Stat. § 44-50 (Priority and payment) - Attorney fees take priority; perfected provider claims are paid from proceeds, typically pro rata, and subject to a statutory cap.
• North Carolina Gen. Stat. § 108A-57 (Medicaid lien) - Separate rules apply if Medicaid paid; resolve per statute in addition to provider balances.

Analysis

Apply the Rule to the Facts: Because one therapy date shows only a partial payment, request an itemized ledger and payoff from the billing service with a HIPAA authorization so they can disclose details. Ask them to reconcile insurer reimbursements on the other therapy dates and confirm whether any balance remains there. Before disbursement, use the ledger to calculate any pro rata reduction if settlement funds are insufficient, then pay the agreed payoff and secure a written release.

Process & Timing

1. Who files: Plaintiff’s attorney. Where: Provider’s patient accounts/lien department (or the billing service’s “lien” or “payoff” team) in North Carolina. What: A written payoff request enclosing a HIPAA authorization, client identifiers, dates of service, and a request for an itemized statement and payoff “good through” date; reference your obligation to address medical liens at disbursement under North Carolina law. When: Send at least 10–14 days before planned settlement disbursement; set a response date in your letter.
2. When you receive the ledger, verify payments/adjustments, ensure insurer-paid dates show $0, dispute errors in writing, and request a revised payoff if needed. If funds are limited, propose a pro rata distribution consistent with statute and ask for written confirmation.
3. Transmit payment with a cover letter and settlement statement, then obtain a written lien/balance release showing a $0 balance for the injury-related dates. Retain all documentation in the file and disburse client funds only after releases are in hand.

Exceptions & Pitfalls

• Government and plan liens: Medicare, Medicaid, TRICARE, and some ERISA plans follow separate lien/subrogation rules and timelines; resolve these in addition to provider payoffs.
• Wrong payee risk: Confirm whether the balance is with the original provider, a billing company, or a collections agency; pay the correct entity and get the release from the party asserting the claim.
• Missing itemization: If the billing service won’t provide an itemized statement, escalate to its compliance/legal unit and note state law requires itemization on request.
• Direct insurer payments: Verify EOBs and contractual write-offs so you do not overpay a date of service already satisfied by insurance.
• Add-ons and interest: Scrutinize late fees or interest; challenge amounts not authorized by contract or statute.

Talk to a Personal Injury Attorney

If you’re dealing with an unpaid therapy balance and need a clean payoff and release before settlement, our firm can help you understand the requirements and handle the requests and negotiations. 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.