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Negotiating Medical Liens

Negotiating Medical Liens

Seeking fair and just compensation for your injuries involves understanding and negotiating your claim’s medical liens and subrogation interests arising from a North Carolina personal injury claim. Medical liens and subrogation interests are a significant obstacle to receiving the compensation you deserve, even after a settlement or award.

In essence, the goal of negotiating your medical liens is to attempt to reach an agreement or compromise with lien holders for a reduction in the amount of money owed to the lien holder. While not all liens are negotiable, the majority are, and those lien holders are often willing to consider a lesser amount. Negotiating a lien before your case settles will likely increase your net recovery and can save you money in the long run.

Negotiating your medical liens can often be as difficult as pursuing fair and just compensation from the insurance company. It is important to note that negotiating medical liens can be extremely technical, and should you need advice or guidance we would recommend contacting an experienced personal injury attorney as soon as possible. This article will provide you with an overview of the negotiation process and tips for negotiating your liens.

When Should I Negotiate a Lien?

It is important that you consider the timing of when you should address your medical liens. It often helps to handle and negotiate your medical lien before the settlement rather than after the settlement, if possible. Negotiating your medical lien, or at least knowing what the lien holders may be willing to accept as early as possible, will provide you with information regarding your actual recovery after expenses.

It is important to note that certain lien holders have more incentive than others to negotiate before the final settlement, given that your ability to compensate the lien holder is drastically reduced if you decide to litigate and are ultimately unsuccessful in that endeavor.

Negotiating or resolving your liens is essential to being able to conclude your claim. Remember that you are obligated by law to reimburse lien holders as required by law. However, the only exception that exists is if the lien holder agrees in writing to accept a different amount than what they are legally permitted.

Who Should I Contact to Negotiate a Lien?

Generally, you should contact the lien holder in writing to negotiate your lien. If you have received a notice of lien, for example, by letter or some other form of documentation, you should refer to those documents for a point of contact. Also, when contacting the lien holder, it is a good idea to have your reference or claim number handy, as it will speed up the process of identifying the case or claim in their system.

The negotiating process often can be tedious and time-consuming. You will likely have to contact the lien holder several times to discuss the lien. Also, be prepared for a lien holder to be firm and hold their ground, as most do these negotiations on a daily basis. The negotiation process is just that, “a process,” so do not become discouraged. Be prepared to make several offers and counteroffers. However, before you consider entering into the negotiation process, consider your legal obligations against what you believe you could have the lien holder accept as a full and final satisfaction of the lien amounts.

What Type of Medical Liens Should I Negotiate?

There are several different types of liens that can affect your settlement. Having knowledge about the types of lien attached to your recovery is essential. The list below provides a general description of what to expect in negotiating certain liens.

Physician’s Liens or §44-49 Liens

One of the most common liens or subrogation interests that can attach to your personal injury settlement or judgment is those allowed for in North Carolina Statutes by medical providers known as physician’s liens. In general, a physician’s lien is a healthcare/medical provider’s financial interest on the proceeds received in a personal injury settlement or judgment.

For example, Roger goes to the chiropractor and does not have insurance. The chiropractor agrees to treat Roger for his accident-related injuries so long as Roger pays the chiropractor out of his accident settlement or award pursuant to N.C.G.S §44-49.

Before paying a physician’s lien, it is recommended that you try to negotiate the lien amount, especially if the recovery does not cover the amount due. While physician’s liens look daunting, the statute (N.C.G.S §44-49) provides accident victims with several tools to ensure that the lien holder does not take the entire settlement or award as reimbursement of the lien. That being said, when your settlement does not cover your medical liens and several medical liens are attached, the medical providers will likely receive only their pro-rata share as defined by statute. Consider trying to negotiate this amount paid pursuant to the statute as a full and final satisfaction of all monies owed to the lien holder. The medical provider may be inclined to accept this amount and forgo pursuing the difference between what is owed and what is payable under §44-49.

Additionally, be aware of the requirements for the perfection of a valid medical provider’s lien. Medical providers with physician liens may not charge for medical records or bills, and if they do, then their lien may be invalid and may not attach to your North Carolina personal injury recovery. It is important to use this and every other tool you have to negotiate to your advantage.

Medicare and Medicaid Liens

Medicare and Medicaid liens are some of the most difficult to negotiate and dispute. It may be necessary to consider contacting an experienced personal injury attorney to assist with negotiating Medicare or Medicaid liens.

Medicare is unique in that reimbursement is required and reimbursement does not have a cap or limit on how much of your personal injury recovery can be taken. While determining what is owed to Medicare may be complicated, negotiating for a Medicare lien reduction involves a very specific and quantifiable process. For more information on Medicare Liens and the negotiations process, please visit the following Medicare Liens article.

Medicaid liens should be handled similarly to that of Medicare. While the laws governing the two are different, the dispute process is similar. However, Medicaid liens differ from Medicare liens in many ways, including the fact that they are statutorily capped, unlike Medicare. Furthermore, Medicaid permits reductions based on hardship arguments, which have to be well-established and significant. For more Medicaid lien information and negotiation strategies, please visit the Medicaid Liens article.

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    The at-fault driver failed to reduce speed and collided with our client's vehicle. Our client passed away shortly after the collision.

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    Vehicle made a left-hand turn, failing to yield the right of way.

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    Client was a passenger in a vehicle that was driving through an intersection when another vehicle ran a stop sign and t-boned the vehicle our client was in.

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    We were able to not only receive policy limits for our client but were able to negotiate her medical bills and liens to ensure that she was able to keep a good portion of the settlement.

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    Elderly client was a passenger in a vehicle that was t-boned in an intersection where a driver failed to yield the right of way.