Detailed Answer — What a medical lien is and how it works in Maryland

A medical lien (sometimes called a provider lien or a hospital lien) is an agreement in which a health care provider agrees to treat you now and be paid later from any money you recover from a responsible third party (for example, an at-fault driver’s insurance settlement or verdict). In practice providers use different documents and names — “medical lien,” “assignment of proceeds,” or they accept treatment based on a lawyer’s letter promising payment (a Letter of Protection or LOP).

Maryland law allows providers and hospitals to assert liens and to seek payment from proceeds of a claim or lawsuit. Providers must follow the statutory and procedural rules that govern liens and claims in Maryland courts. For the state code governing liens and related court procedures, see the Maryland Code, Courts & Judicial Proceedings: https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=cjp. For practical help on court procedures and forms, the Maryland Judiciary website is a useful resource: https://www.mdcourts.gov/.

Typical steps to find and obtain treatment on a lien basis

1. Contact a personal-injury attorney or ask for referrals. Many personal-injury attorneys keep lists of local doctors, urgent care centers, chiropractors, and physical-therapy clinics that will treat patients on a lien or accept a Letter of Protection. Even if you do not hire an attorney immediately, ask attorneys in your area which providers they work with.
2. Call hospital billing/financial services and local injury clinics. Ask: “Do you accept treatment on a lien or deferred payment pending settlement?” Some hospital emergency departments and trauma centers provide initial treatment and can discuss billing arrangements afterward. Many outpatient clinics (orthopedics, pain management, PT, chiropractors) commonly accept liens.
3. Understand the documentation you will be asked to sign. A provider lien document or assignment typically describes the provider’s right to be paid from settlement proceeds. A Letter of Protection from an attorney promises the provider payment from any recovery. Get copies of any signed lien or LOP and read them carefully: note scope (which bills are covered), duration, and whether interest or collection fees are allowed.
4. Confirm coverage priorities and third-party rules. If you have Medicare, Medicaid, or other government health benefits, those programs have special rules and may require repayment from any recovery (federal law may create a lien or claim for conditional payments). Inform any provider and attorney about government benefits immediately so those obligations can be handled correctly.
5. Get all care documented and keep records. Good medical records, itemized bills, and clear diagnostic notes help a provider establish the medical necessity of care and the connection to the accident — which supports a provider’s lien claim and your personal-injury case.
6. Watch deadlines and filing requirements. Some types of liens require filing or notice within specific time limits to protect priority against other creditors or claimants. Your attorney or the provider’s billing department should explain any filing steps required to perfect the lien under Maryland procedure.
7. Negotiate payment terms in advance when possible. Providers sometimes accept reduced payment from settlement proceeds in exchange for agreeing to a lien. If you have an attorney, they usually negotiate these amounts when resolving your claim.

Who commonly accepts liens

Providers that frequently accept lien arrangements include emergency departments, trauma hospitals, orthopedic surgeons, chiropractors, physical therapists, pain-management specialists, diagnostic imaging centers, and some specialty clinics. Availability depends on the provider’s billing policies and the strength of your claim.

What to expect after treatment on a lien

• Providers will bill you and may file a claim against any settlement proceeds to recover payment. Do not ignore bills; instead, tell the provider an attorney is handling the claim if you have one.
• If you do not hire an attorney, providers may be less willing to defer collection. An attorney’s involvement and an LOP are often persuasive.
• If multiple providers claim payments, liens may compete. Priority and enforceability depend on filing and notice rules, the type of lien, and court procedures.

When you should get a lawyer

If your case involves serious injury, disputed fault, complex medical bills, Medicare/Medicaid, or multiple medical providers, consult a personal-injury attorney early. An attorney can:

• Advise whether a provider’s lien is valid and enforceable;
• Negotiate lien reductions;
• Handle notices and filings required to preserve or dispute liens;
• Coordinate repayment obligations with any government payors (Medicare/Medicaid).

Useful Maryland resources

• Maryland Code, Courts & Judicial Proceedings (statutes on liens and court procedures): https://mgaleg.maryland.gov/mgawebsite/Laws/StatuteText?article=cjp
• Maryland Judiciary (court information and self-help resources): https://www.mdcourts.gov/

Important: This answer explains general practices and procedures. Specific lien rules, deadlines, and filing requirements depend on the type of provider, the facts of your case, and applicable Maryland statutes and court rules. Speak with a Maryland attorney or the provider’s billing office to confirm what applies to your situation.

Helpful Hints — Practical steps you can take right now

• Call 3–5 local personal-injury attorneys and ask for provider referrals even if you are not ready to hire — many will give referral names.
• When you call a clinic, ask specifically: “Do you accept treatment on a medical lien or a Letter of Protection?” and request their lien form to review before you sign.
• Tell every provider immediately if you have Medicare or Medicaid. Federal rules may require repayment if they make conditional payments.
• Get any LOP or lien agreement in writing and keep a copy. Note what services, dates, and amounts are covered.
• Track all medical appointments, records, and invoices in a single folder or digital file to show how treatment relates to the accident.
• Ask the provider whether they are willing to accept a percentage reduction from the settlement — many providers will negotiate for a quicker, guaranteed payment.
• If bills are sent to collections, contact the provider and explain the lien/LOP arrangement — do not ignore collection letters.
• If you cannot find providers locally who accept liens, ask about short-term options (urgent care or emergency department) and then ask those facilities for referrals to specialists who accept liens.

Where to get help: If you are unsure about a lien form, or if a provider insists you sign something you do not understand, contact a Maryland personal-injury attorney or the Maryland State Bar Association referral service for guidance.

Disclaimer: This article is for general informational purposes only and is not legal advice. It does not create an attorney-client relationship. For advice about your particular situation in Maryland, consult a licensed Maryland attorney.