In many states, hospitals and medical insurance companies can place a lien against a personal injury settlement. If the victim has filed a personal injury lawsuit, then the cost of the patient’s medical bills may be filed as a hospital lien against the settlement. Doctors are required to provide patients with care even if they cannot pay for it, which means they can put what’s called a lien against the patient’s settlement or judgment. This ensures that the doctors are compensated for the care that they provided to the patient.

What Is A Lien?

A lien is something that is put into place to ensure a person, group, or business is compensated for services or goods that are provided to someone else. If the patient filed a bodily injury insurance claim or personal injury lawsuit to recover the cost of their medical bills, the health insurer who paid for the medical costs may be able to file a lien against any proceeds from the patient’s lawsuit. This is known as subrogation. 

A medical lien demands repayment that is placed against your personal injury case. Whenever a personal injury lawsuit is filed, the amount of money the patient has already spent and could spend on future treatments are considered.

What Is A Hospital Lien?

Depending on the state an accident victim was treated in, hospitals and sometimes other medical providers can file a hospital or physician’s lien against an accident patient’s liability settlement or personal injury judgment. In states where other medical providers are not allowed by statute to file a lien, medical providers will ask the patient to sign a lien letter stating that they submit to a lien against their personal injury settlement. Where the law allows hospitals and/or other medical providers to file a lien, there are requirements that they must follow when placing a lien against the patient’s settlement.

• The lien must be filed within a specific time period, usually before the patient is paid from the settlement or judgment.
• The lien must have certain information included on it as defined by the state’s law, often including the patient’s proper name, correct address, the name and address of the hospital, the amount of the lien being claimed, and the dates of service.

Hospital staff must gather accurate information at the time of the patient’s accident-related intake or discharge. All liability insurance information, address, and names must be accurate. Inaccurate or the lack of adequate information can hinder a medical lien and make it difficult for a hospital to collect what is owed. If the hospital does not follow these requirements, their lien may not be enforced. One thing to consider is that it does not mean the patient is not responsible for the bills. This just means that the hospital may not be able to collect payment directly from the patient’s settlement. Further, if a patient has private health insurance, it must be billed first, and the lien can only be filed on any patient portion left over after the health insurer has made payment to the hospital.

Risky for Medical Care Providers

Providers and hospitals could wait years to receive their payment once a medical lien is placed, and the patient might not receive any damages once it’s all over with. Some hospitals will negotiate timely payments instead of getting a medical lien out against the patient to avoid this.

If a patient retains an attorney, the legal counselor can often negotiate with the hospital to reduce the amount of the lien. And in some states, the attorney may require the hospital to pay a pro-rata portion of his fees under the “Common Fund Doctrine.”. This is because the attorney is credited with creating the pool of funds from which the hospital is going to be paid, and therefore it is considered “fair” that the hospital pays the attorney for his or her efforts.

Cover Hospital Expenses

Many medical expenses can be covered by a personal injury lien. These expenses include:

• Nursing services
• All ambulance services
• Emergency room services
• Surgical expenses
• Medical supplies
• Physician services
• Dental services obtained in the hospital
• Drugs and medications
• Hospital services

Now What?

The professionals at the Midland Group understand the ins and outs of a hospital lien from both perspectives: that of the hospital and the patient. Contact us today to get the help you need during these difficult circumstances, or claim your FREE Accident Reimbursement Assessment & Custom Report tailored to YOUR facility!

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The Importance of Immediately Checking All Payment Options

When a patient is first admitted, it is the hospital staff’s duty to check all payment options. A hospital billing specialist must be able to handle the following effectively and efficiently

1. Patient’s Payment Responsibility: From the gate, the medical billing specialist should immediately grasp the individual’s responsibility for payment. All patient responsibility levels differ but with enough experience and skill, a trained medical specialist will quickly be able to decipher the situation.
2. Insurance Coverage Analysis: A medical billing specialist will evaluate and analyze the patient’s insurance cover and all relative medical charges. This will help the hospital staff prepare accurate billing forms that are easy to understand.
3. Collecting Owed Revenue: The job of the hospital’s billing specialist includes collecting accurate payments form the insurance plans and also the patients. If the patient cannot readily pay their balance then an acceptable payment plan must be devised the benefits not only the hospital but also the patient.

Patient Information Must be Filled Out Right the First Time

Simply handing a patient a form and expecting them to fill it out without going over all aspects is a lax behavior on the part of the hospital admittance staff. Ideally, a hospital staff member should sit with the person and go over all parts of the admittance and insurance information paperwork to make sure that everything is satisfactorily filled out. Any gaps or empty questions can make billing and the collection of revenue at a later date difficult and time-consuming. It is better to correctly fill out everything the first time. Valuable time and resources are often wasted trying to gather information that should have initially been entered at admittance. Plus, a hospital will suffer from payment delays if all information is not correct on the forms.

Always Ask the Correct Questions at Registration

Ideally, all hospital registration staff needs to be trained in exactly what questions to ask the patient at the time of registration. If all questions are asked and recorded then the entire process of billing will go much easier than if the registration staff member fails to ask the appropriate question.

Billing Mistakes Happen but Steps Should be Taken to Fix Them

It is often hard for a hospital staff member to acknowledge when they have made a mistake and then take the steps to fix it. Many will simply shuffle the problem away or try to sidestep it. This can ultimately cost time and revenue. Mistakes happen and they should be dealt with promptly by the hospital staff so the entire billing process does not stall.

The professionals at the Midland Group know exactly how important it is to work on building good habits among hospital staff so that everything functions correctly and the hospital gains the maximum about of revenue. 

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Medicare Third-Party Claims

Nowadays, it is not uncommon for Medicare recipients to also carry additional insurance coverage to pick up the loose ends. In such situations, a third-party insurance company must be handled. By law, a third-party insurance company must be billed and pay before Medicare will step in and pay their share. This makes it extremely important that all third-party claims are filed in a timely manner.

Importance of  Third-Party Billing Specialists

All third-party billing specialists must be well versed in their state’s laws and regulations. They need to take every avenue available to ensure that legal liability of the third-party which will ultimately determine their payment responsibility.

Third-Party Groups

There are numerous third parties that are often liable to pay for a portion of the medical and hospital bills.

Third-party groups include but are not limited to:

• Most group health plans
• Many types of self-insured plans
• Pharmacy plans and benefits
• Court-ordered healthcare coverage
• Managed care organizations
• Settlements paid by a liability insurer
• Long-term care insurance
• Worker’s compensation
• Medicare
• Federal coverage programs

Identifying Third Parties

Any time a person applies for state or federal medical assistance the state gathers third-party insurance information. The information is periodically updated when the person’s Medicare eligibility is up for renewal. States continuously gather data to see if a Medicaid covered individual might also be covered by automobile insurance or workman’s compensation liability insurance.

Hospitals Lack Necessary IT Resources and Skilled Staff

Very few hospitals have the staff who possess the experience, knowledge, and talent to pursue third-party claims. The hospitals also lack the IT resources or capital to successfully achieve the job so they end up losing out on substantial revenue. An inefficient collection process is going to hurt the hospital’s bottom line

Third Party Liens Can Help Collect Revenue

Many times patients are involved in an accident and must file a legal lawsuit in order to force the third-party to pay the incurred bills. Although a person’s health insurance will pay for many of the bills, often not everything is covered. Eventually, the injured patient may receive reimbursement from a third-party. Many hospitals are faced with filing liens to ensure that at some point they receive payment from a third-party settlement.

Hospital Revenue Claims Losses

The sad reality is that most third-party liability claims will be either unpaid or underpaid. The money that is being left on the table is substantial and should not be overlooked. Depending on the size and location of the hospital, it could be facing millions of dollars in losses every year due to inadequate claims handling practices. Pursuing such claims may seem time-consuming and tedious but the possible revenue recoup is substantial.

At the Midland Group, we know the importance of having a skilled claims staff handle your third-party liability and injury claims. Book your free assessment today to see how you can maximize all potential revenue surrounding all types of liability claims.​

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Personal Injury Settlements and Hospital Liens

Patients often do not realize that the hospital can file a lien against their personal injury settlement. Any time a person files a case in order to recoup medical expenses and other losses due to an injury the hospital has the right to lien the settlement in order to recoup their expenses. The hospital is not trying to take money from you for the unpaid expenses but instead get back the money owed by the at-fault third party.

Often Unknown Lien Practices

Here are five practices involving liens that many people do not realize.

1. State Laws: Not all states allow hospitals to file a lien against a personal injury settlement for unpaid medical expenses.
2. Lien Statutes: The typical lien statutes state that a hospital has 180 days to file a lien at the recorder’s office of the county. The lien papers must include the name and address of the hospital. It should also clearly display the dates of service.
3. Enforceable: If a lien is not followed through correctly and according to the state laws then it is non-enforceable.
4. Responsibility: Many people mistakenly believe that if a hospital files a lien against their personal injury claim then they do not have to pay their hospital bill. Unfortunately, regardless of the lien, the patient must still pay the entire hospital bill.
5. Health Insurance: In some states, if there is health insurance available then the hospital must bill the health insurance. They cannot file a lien for the remaining amount after the health insurance company pays their portion. However, in other states, the hospital can file a lien immediately in order to receive the full amount of the money owed them instead of a portion of the personal injury settlement.  In such circumstances, the hospital immediately files a lien against the personal injury settlement instead of billing the insurance. This allows them to recoup the entire amount of the bill instead of only a portion as they would if they were to bill the insurance.

Hospital Lien Balances can Often be Reduced

If a patient retains an attorney, the legal counselor can often negotiate with the hospital to reduce the amount of the lien. The attorney may also create a fund doctrine. With this system, the attorney is entitled to pull reimbursement fees.

Inflated Hospital Liens

Many people become frustrated when a hospital lien gains their personal injury claim because the amount owed is often inflated considerably. This is not always the case, but it often happens. The full amount of the hospital expenses can be substantially higher then what the hospital would typically bill the patient’s health insurance provider.

Cover Hospital Expenses

Many medical expenses can be covered by a personal injury lien. These expenses include:

• All ambulance services
• Emergency room services
• Physician services
• Nurse services
• Hospital services
• Medical supplies
• Dental services obtained in the hospital
• Drugs and medications
• Surgical expenses

The professionals at the Midland Group understand the ins and outs of a hospital lien from both perspectives: that of the hospital and the patient. Book your free assessment today to see how you can maximize all potential revenue surrounding all types of liability claims.​ 

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Hospitals are probably missing out on revenue by not actively pursuing hospital accident liens. Unfortunately, the number of motor vehicle accidents that result in injury are mounting. From 2014 to 2015, there was a 14 percent increase in accidents within injury. The majority of patients injured in an auto accident are self-pay. It is estimated that approximately 25 percent lack any commercial or government health insurance. As a result many hospital accident liens are being overlooked.

Auto Injury Claims Continue to Increase

The number of auto injury claims continue to rise at a staggering rate. Bodily injury claims increased by 32.3 percent from 2005 to 2013. The average claim was $11,738, but by 2013 it had reached $15,506, according to a study by the Insurance Research Council (IRC). The study went on to show that the average cost of Personal Injury Protection (PIP) claims also experienced a dramatic increase of 38 percent. The price of claims went from $5,802 to $8,017.

States With Legal Protection For Secure Payment

Now, 37 states have legal protection laws that allow hospitals to secure payment from self-pay patients if they were injured in an auto-related accident. These laws are considered hospital lien laws.

Little Known Facts About Auto Crashes and the Resulting Injuries

• 18 billion is spent on medical care as a result of auto-related injuries.
• In 2014, 2.5 million people went to the emergency room as a result of an injury that was sustained in an auto accident and 10 percent ended up being hospitalized for further treatment.
• About $57,000 per person is spent on inpatient hospitalization after an auto accident.
• The average cost of an emergency room visit after an auto accident is $3,300 per person.
• For every fatality as a result of an auto-accident, eight other individuals typically end up hospitalized and 100 individuals are taken to the emergency room.
• Approximately 3 percent of a hospital’s revenue comes from auto accidents and workman comp specialty claims.
• In the United States, people spend more than a million days in the hospital as a result of auto vehicle accidents.

Increasing Revenue From MVA Claims

Motor Vehicle Accident (MVA) financial class is an ideal way for hospitals to garner revenue. Ideally, MVA’s need to be treated as a separate financial class by hospital billing. When comprehensively managed, MVA financials have the ability to render far more revenue than the typical 2 percent that hospitals have historically collected by erroneously billing them to health insurance or self-pay only.

1. MVA claims need to be treated separately and have their own financial class.
2. MVA claims are notoriously difficult to manage but with proper management, they can return substantial revenue.
3. Patients need to be directly engaged to make sure that all information gathered about the accident is accurate. Identification of all payment resources needs to be gathered immediately to minimize the patient’s financial responsibility.
4. All insurance leads need to be properly vetted and billed correctly the first time.

At the Midland Group, we understand what it takes to optimize the revenue garnered from hospital accident liens. Please contact us today to see how we can help ensure that all MVA claims are handled and billed correctly.

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