Disclaimer

This article is for general informational purposes only and does not constitute legal advice. I am not a lawyer. If you have or may have a legal claim, consult a qualified South Carolina attorney who can evaluate your situation and advise you on next steps.

Detailed Answer — Step-by-step: find, verify, and resolve medical liens in South Carolina

When you reach a settlement in a South Carolina personal injury case, medical providers and payors (private insurers, Medicare, Medicaid, and state programs) can assert liens or reimbursement claims against the settlement proceeds. Follow these steps to identify and resolve those claims so you can safely distribute settlement funds.

1. Collect all medical and billing records early.

   Ask your attorney (or, if you represent yourself, each medical provider) for complete medical records, itemized bills, statements, ledgers, and any correspondence that indicates an outstanding balance or a lien. These documents list providers, dates of service, charges, payments, write‑offs, and often mention if the provider has filed a lien or received an assignment of rights.

2. Search public records for filed liens.

   Some South Carolina lien claims—especially hospital liens or provider liens—may be filed with the county clerk or recorded in public records. Contact the clerk of court or register of deeds in the county where treatment was provided and search for lien or judgment filings. You can also search the South Carolina Code and public resources at the South Carolina Legislature website (https://www.scstatehouse.gov) for statutory guidance on lien procedures and recording requirements.

3. Identify possible payors with subrogation or reimbursement rights.

   Common payors include private health insurers, Medicare, and South Carolina Medicaid (SCDHHS). These entities frequently have contractual or statutory rights to be reimbursed from a claimant’s recovery. Contact insurers and SCDHHS to ask whether they assert a lien or subrogation claim on the claim. For SCDHHS (Medicaid) inquiries, visit the South Carolina Department of Health and Human Services: https://www.scdhhs.gov. For federal Medicare rules, see https://www.cms.gov or Medicare Secondary Payer resources on the CMS site.

4. Request itemized statements and payoff letters.

   Ask each provider, insurer or subrogee for a current payoff demand or written statement of the amount claimed, plus an itemization showing the balance after payments and write‑offs. A proper payoff letter should show the date(s) of service, billed charges, payments made by the patient or insurer, contractual adjustments, and the claimed remaining balance.

5. Confirm whether the provider has an assignment of benefits or a lien.

   Some providers obtain an assignment of rights from the patient (assignment of benefits) or file a statutory lien. Confirm whether a provider claims an assignment, a statutory lien, or merely an unpaid bill. The proof (a filed lien, an assignment document, or a court judgment) affects your options for defense or negotiation.

6. Calculate the realistic lien amount.

   Not all billed charges are collectible. Consider insurance payments, contractual write‑offs, Medicare allowable amounts, and any payments already made. Providers often accept a reduced lump‑sum payoff. If a provider’s demand looks inflated, request a ledger showing how the balance was calculated and supporting documentation for each charge.

7. Negotiate reductions and releases in writing.

   Negotiate lien payoffs before disbursing the settlement. Providers often accept a reduced figure if you offer a lump‑sum payment. Make sure any agreement includes a signed lien release or satisfaction statement that identifies the claim and confirms full settlement of the lien. Do not rely on oral promises—get written releases.

8. Settle disputed claims by court action if necessary.

   If a lien’s validity or amount is in serious dispute, you or your attorney can ask a South Carolina court to determine the lien’s validity and prioritize distribution. The court can approve escrow arrangements, order funds paid into court, or enter an order determining lien amounts. Holding settlement funds in escrow or using a court interpleader can protect you from future claims while disputes are resolved.

9. Protect net recovery for attorney fees and costs.

   Discuss with your attorney how liens will affect attorney fees and costs. In many cases, attorney fees are calculated based on the gross or net recovery depending on your fee agreement and applicable law. Have your attorney obtain written payoff agreements and releases that reflect the settlement distribution so fees and costs are clear and defensible.

10. Obtain final written releases and proof of payment before disbursing funds.

    Before you distribute settlement proceeds, obtain:

    • Signed lien releases or satisfaction of lien documents from providers;
    • Written subrogation waivers or payoff confirmations from insurers or SCDHHS;
    • Clear documentation that Medicare’s conditional payment issues (if any) are resolved or a settlement has accounted for Medicare recovery.

    Keep these documents in your closing file to prove you resolved claims and to protect against later demands.

For statutory guidance and to research specific South Carolina statutes that may affect medical liens and priorities, consult the South Carolina Code of Laws via the South Carolina Legislature website: https://www.scstatehouse.gov. For Medicaid subrogation questions, contact SCDHHS: https://www.scdhhs.gov. For federal Medicare recovery rules see the Centers for Medicare & Medicaid Services: https://www.cms.gov.

If you are unsure how a particular lien will affect distribution, or if a lienholder refuses to release its claim after a negotiated payment, talk with a South Carolina personal injury attorney or ask the court to resolve the dispute. The South Carolina Bar can help you find an attorney at https://www.scbar.org.

Helpful Hints

• Start lien identification early—before settlement negotiations conclude.
• Get payoff demands and releases in writing; do not rely on verbal assurances.
• Ask for itemized bills and a ledger showing payments and write‑offs to spot overcharges or errors.
• Contact SCDHHS if you received Medicaid benefits; Medicaid likely has a recovery claim.
• If Medicare may have paid, report the settlement promptly and resolve Medicare conditional payments—CMS enforces strict recovery rules.
• Consider placing settlement funds in escrow or using the court’s interpleader mechanism to avoid exposure to competing claims while resolving liens.
• Negotiate aggressively—many providers accept significantly reduced lump‑sum payoffs.
• Keep detailed records of every communication, offer, payment, and release.
• When in doubt, consult a South Carolina attorney experienced in personal injury settlements and lien resolution.