Short Answer

In North Carolina, medical providers can assert a lien against your personal injury settlement for reasonable charges related to your treatment, but those liens are limited by statute and must meet specific requirements. If a physical therapy office missed your health insurer’s timely-filing window, you can challenge the lien’s enforceability or amount, negotiate a withdrawal or reduction, and, if needed, ask a court to decide—while your lawyer holds the disputed funds in trust.

Understanding the Problem

You’re asking whether you can get a North Carolina physical therapy lien removed because the provider failed to submit one date of service to your insurance on time. You already have a personal injury settlement with multiple liens and a subrogation claim handled by OPTUM, and attorney’s fees will come off the top before lien payments. You want to know if you must pay that PT lien out of pocket or if the provider should remove it.

Apply the Law

Under North Carolina law, medical providers may assert a lien on personal injury recoveries for charges related to the injury. Those liens attach to settlement proceeds held by your attorney, but they are limited: attorney’s fees are paid first, and the total amount payable to all medical provider liens is capped by statute. Only reasonable, injury-related charges are recoverable, and providers must cooperate by supplying itemized statements and records upon request. Disputes are typically resolved by negotiation; if not, a judge in Superior Court can decide the enforceability or amount before funds are disbursed.

Key Requirements

• Covered services: The lien only applies to reasonable charges for treatment connected to the accident.
• Provider cooperation: Upon request, the provider must furnish an itemized statement and pertinent records without charge; refusal can jeopardize lien recovery.
• Statutory cap: After attorney’s fees are paid, all medical provider liens together cannot exceed a statutory percentage of the net recovery; providers share pro rata if funds are short.
• Reasonableness of amount: You may challenge inflated or improper charges; missed timely-filing with health insurance can inform what a “reasonable” charge would have been.
• Forum: Most liens resolve informally; unresolved disputes can be brought in Superior Court for a determination before disbursement.

What the Statutes Say

• North Carolina Gen. Stat. § 44-49 (Medical provider lien) - Creates liens for providers’ reasonable charges and requires cooperation with records and itemized statements.
• North Carolina Gen. Stat. § 44-50 (Distribution and cap) - Sets priority for attorney’s fees and caps total payments to medical provider liens from the settlement.

Analysis

Apply the Rule to the Facts: Your PT lien is for one date of service the provider failed to submit to insurance on time. Start by demanding an itemized statement and relevant records at no charge and review whether the billed amount is reasonable. Use the missed timely-filing to argue the reasonable charge should be no higher than the insurer-allowed amount or customary cash rate. Then apply the statutory distribution cap after attorney’s fees to show the available pro rata share. If the provider won’t reduce or withdraw, your lawyer can hold the disputed amount and seek a court ruling.

Process & Timing

1. Who files: You (through your personal injury attorney). Where: First by written demand to the provider; if unresolved, in the Superior Court in your North Carolina county. What: Send a records/itemization request and reduction/withdrawal demand citing lien limits and reasonableness; if needed, file a declaratory action or interpleader and hold disputed funds in trust. When: Do this before disbursing settlement funds.
2. Negotiate reductions using the insurer’s denied timely-filing as a benchmark; many providers respond within 2–4 weeks once they see the statutory cap and pro rata math.
3. If the dispute persists, ask the court to determine enforceability/amount; after the order, your attorney disburses and obtains a lien release or satisfaction.

Exceptions & Pitfalls

• Government and certain plan claims (for example, Medicare, Medicaid, State Health Plan, or self-funded ERISA plans often administered by vendors like OPTUM) follow separate reimbursement rules and may not be limited by the medical-provider lien cap.
• If the provider refuses to supply itemized charges and pertinent records at no cost when requested, object to paying on the lien until they comply.
• Only reasonable, accident-related charges are recoverable; challenge duplicate entries, unrelated care, and amounts exceeding typical insurer-allowed rates when timely-filing was missed.
• Never disburse your settlement until the lien picture is clear; keep disputed amounts in the attorney trust account to avoid personal collection risk.

Conclusion

In North Carolina, a physical therapy provider can claim a lien on your personal injury settlement only for reasonable, accident-related charges, and total medical-provider lien payments are capped after attorney’s fees. When a provider missed insurance timely-filing, you can use records and itemized charges to contest reasonableness and seek withdrawal or reduction. Next step: have your lawyer demand a no-cost itemization, propose a cap-based reduction, and, if needed, file for a court determination before any funds are released.

Talk to a Personal Injury Attorney

If you're dealing with a disputed physical therapy lien on your North Carolina injury settlement, our firm can help you evaluate reasonableness, apply lien caps, and protect your net recovery. 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.