FastCounsel

Disclaimer: This is general information, not legal advice. I am not a lawyer. For advice specific to your case, consult a licensed Montana attorney.

Overview — What a medical lien is and who can assert one

A medical lien is a legal claim by a health care provider, hospital, insurer, or government health program seeking repayment from a personal injury settlement or judgment. In Montana, liens and subrogation claims can come from private providers, health insurers, workers’ compensation carriers, and government programs such as Medicaid and Medicare. Resolving these claims is a required step before you or your attorney can distribute settlement money to you.

Step-by-step process to verify and clear medical liens in Montana

1. Identify potential lienholders early.

   Make a list of any medical providers, hospitals, urgent-care centers, ambulance companies, health insurers, and government payer (Medicaid/Medicare) that paid for treatment related to the injury. Your medical records, billing statements, and demand letters from the defendant’s insurer are primary sources.

2. Request written lien statements and itemized bills.

   Ask each provider or billing company for a written lien statement that states (a) the amount claimed, (b) the services and dates, (c) whether the bill was reduced by contract or write-off, and (d) what authority they rely on to claim a lien or subrogation. Also request proof of assignment or any contract that created the lien claim. Keep all communications in writing.

3. Check for government-payor claims (Medicaid / Medicare).

   Government payors have separate recovery programs. Montana’s Medicaid agency pursues third-party liability recoveries. Federal Medicare has a Medicare Secondary Payer (MSP) recovery process that may require you to request a conditional payment amount from CMS. Contact the Montana Department of Public Health and Human Services and CMS early so you can get official payoff demands and avoid surprises. General Montana code and agency pages are available at the Montana Legislature and Montana DPHHS sites:
   Montana Code Annotated (MCA) and Montana DPHHS.

4. Compare claimed amounts with medical records and insurance payments.

   Verify each claim is for treatment related to the injury and that billing reflects contractual adjustments (e.g., insurer write-offs). Some providers list the full charge but have already accepted a smaller payment from your health insurer; lien demand should reflect any payments or contractual reductions.

5. Negotiate reductions where appropriate.

   It is common to negotiate medical liens down. Providers and insurers often accept a percentage of billed charges, especially if you are represented. A common outcome in many jurisdictions is a substantial reduction if the recovery is the only realistic source of payment for providers. If a government payor asserts a claim, there may be statutory rules or administrative procedures affecting negotiability.

6. Obtain written payoff demands or lien releases.

   Before disbursing any settlement funds, get written payoff statements or a signed lien release showing the exact amount the provider will accept to release its lien. For government payors, obtain an official letter showing the amount required to close their claim.

7. Use escrow or court procedures if there is a dispute.

   If a lienholder’s demand is disputed or multiple claimants fight over the settlement money, your attorney may place funds in escrow, request the court to approve distribution, or file an interpleader action to ask the court to decide priority. This prevents you from being personally liable while disputes are resolved.

8. Close the claims and finalize distribution.

   Once all lienholders provide written releases or the court orders distribution, the settlement can be paid out according to the agreement and applicable law: attorney fees, costs, lien payoffs, and the net amount to you.

Typical timeline — how long will this take?

Exact timing varies with the nature of the lien and whether a government payor is involved. Typical ranges:

• Private provider or hospital liens: 2 to 12 weeks if documentation is straightforward and parties negotiate in good faith.
• Commercial insurer subrogation claims: 4 to 12 weeks, sometimes longer if insurer assesses future damages or coverage questions.
• Medicaid (state) recovery: often 6 weeks to several months. The state agency has its own internal processes and statutory procedures; expect administrative timelines.
• Medicare (federal) conditional payment / MSP resolution: commonly several months and sometimes 6–12+ months if you wait for CMS to issue a final demand. There are processes to obtain conditional payment amounts more quickly, but they still take time.
• If there is a dispute that requires escrow, settlement approval, or interpleader, plan for 1–6 months or longer depending on court schedules.

Practical tip: Start the lien-clarification process as soon as liability and damages are settled or when you have a settlement offer. Early action shortens the overall timetable.

Where Montana law matters

Montana statutes and administrative rules can affect how state programs pursue recovery and whether particular claims can be reduced or must follow a statutory priority. For statutory text and to look up Montana statutory references, use the Montana Code Annotated index at the Montana Legislature’s website: https://leg.mt.gov/bills/mca_toc/. For matters involving Medicaid recovery, contact the Montana Department of Public Health and Human Services: https://dphhs.mt.gov/.

When you should get an attorney involved

• If multiple lienholders assert competing claims.
• If government payors (Medicaid/Medicare) assert recovery rights.
• If a lienholder refuses to produce an itemized statement or will not reduce an unreasonable demand.
• If your settlement funds are at risk or an insurer threatens to withhold coverage funds.

Helpful Hints

• Document everything: keep copies of medical records, bills, contracts, letters, and payoff statements.
• Ask for written lien or payoff letters that itemize services, payments, and reductions.
• Start the process early—especially if Medicare may be involved.
• Be aware that billed charges are often higher than the allowed or collectible amount; negotiate based on what was actually paid or contractually allowed.
• Do not pay providers from your pocket until you have written releases or court approval, unless advised by counsel.
• If you have Medicare or anticipate future Medicare coverage, notify CMS and request the official conditional payment amount to avoid later recovery claims.
• Consider hiring an attorney experienced in Montana personal injury settlements and lien resolution; attorneys often obtain larger net recovery for clients after lien negotiation.