Detailed answer: how lien-based treatment works and how to find providers in Montana

What “treatment on a lien” and a Letter of Protection (LOP) mean

Treating on a lien means a medical provider agrees to be paid from any money you later recover from a personal injury claim (settlement or judgment) instead of being paid up front. Many providers use a written agreement that creates a claim against the recovery. A Letter of Protection (LOP) is a promise from your attorney to ask the provider to wait for payment from the case recovery. An LOP itself does not create a statutory lien; it is a contractual promise between the provider and your attorney.

Does Montana law allow medical providers to place liens?

Montana law recognizes certain lien rights and mechanisms for creditors and providers. If you want to review Montana statutes and any specific lien rules that might apply to hospitals or medical providers, start with the Montana Code Annotated (MCA) at the Montana Legislature website: https://leg.mt.gov/bills/mca/. If a provider says they will place a statutory lien, ask for the statute citation and confirm how and when they will file it.

Which types of providers commonly treat on a lien?

• Personal injury / PI medical clinics (including physical therapy and chiropractic clinics)
• Some individual physicians (especially those who work with injury attorneys)
• Specialists in orthopedics, pain management, neurology who see many PI patients
• Smaller hospitals or community clinics (larger hospitals sometimes have strict billing rules or a statutory lien process)

How to find providers in Montana who will treat on a lien

1. Contact personal injury attorneys for referrals. Many PI lawyers work regularly with medical providers who accept LOPs or treatment-on-lien agreements. If you can, consult an attorney early — they can provide a written LOP and refer reliable providers.
2. Call clinics and ask clearly about lien policies. Use direct language: “Do you accept patients on a lien/letter of protection?” Ask what paperwork they require, whether they file liens, and their billing timeline.
3. Speak with hospital billing or patient financial services. Some hospitals will accept delayed payment or implement a hospital lien under state law. Ask whether the hospital uses a statutory lien procedure or requires payment/guarantee.
4. Search for “personal injury clinics” or “medical lien clinics” in your region. Clinics that specialize in PI cases often advertise that they accept LOPs or liens.
5. Use community health centers or sliding-scale clinics as a short-term option. They may provide care while you arrange PI payment options, but they often expect you to apply for financial assistance rather than wait for a settlement.
6. Ask dental and specialty practices about lien arrangements. For injuries requiring dental or specialty care, some providers will accept LOPs for trauma-related treatment.

What paperwork and steps to expect

• Bring identification, insurance information (even if you plan to pursue a claim), and any accident reports or photos.
• Get a written treatment-on-lien agreement or an LOP from an attorney. Do not rely on verbal promises.
• Make sure the agreement describes how payment will be taken from any settlement, what percentage (if any) the provider will take, whether interest or collection fees apply, and time limits for payment.
• Confirm who will file any lien or claim against the settlement and when it will be filed (before or after settlement).
• Keep copies of all medical notes, bills, and signed lien agreements. These documents will matter in settlement negotiations.

How settlements and liens interact

If a provider has an enforceable lien or a valid contractual claim for payment, the settlement process usually must clear those claims before you or your attorney can disburse net proceeds to you. Providers that accept LOPs typically expect payment from the settlement and may negotiate a reduced balance. Without an attorney, you may struggle to resolve competing claims—attorneys can act as a clearinghouse for medical liens and negotiate reductions.

Risks and limitations

• Not every provider will agree to wait; major hospitals sometimes require immediate payment or will assert statutory rights.
• An LOP is a contractual promise, not an automatic lien on settlement funds; collection may require a lawsuit if no settlement occurs.
• If your case does not produce a recovery, providers might bill you directly and may pursue collection.
• Make sure any written agreement limits how long the provider can pursue payment and whether they will charge interest or collection fees.

When you should consider hiring an attorney

Talk to a Montana personal injury attorney if you have significant injuries, large medical bills, or multiple providers claiming payment. An attorney can (1) issue an LOP, (2) coordinate medical providers, (3) negotiate reductions with providers, and (4) ensure lien filings (if statutory) are handled properly. If you cannot afford a consultation, many PI attorneys offer free case evaluations.

Practical example (hypothetical)

Jane is injured in a car crash in Billings and has no available health insurance. She calls a nearby PI clinic that advertises acceptance of Letters of Protection. She consults a PI attorney who provides a written LOP and refers Jane to an orthopedic surgeon who accepts the LOP. The clinic documents care under the LOP, provides copies of bills, and later negotiates a reduced payment when Jane settles her case. Because the agreement was written and documented, Jane’s settlement disbursement team can clear the medical claim before she receives her net recovery.

Where to read Montana law and learn more

For statutory language and any statutory lien rules that might apply to hospitals or providers in Montana, consult the Montana Code Annotated: https://leg.mt.gov/bills/mca/. If a provider refers to a specific Montana statute, ask them for the citation and review the statute on the Legislature’s site or discuss it with an attorney.

Disclaimer: This is general information about Montana practice and not legal advice. It does not create an attorney-client relationship. For advice about your specific situation, consult a licensed Montana attorney.

Helpful hints

• Get everything in writing. Ask providers for written lien agreements and keep copies.
• Ask providers to explain whether they will file a statutory lien, rely on an LOP, or require court action to enforce payment.
• If possible, get a short attorney consult. Even a one-time meeting can produce an LOP and referrals to lien-friendly providers.
• Ask about reductions. Many providers will accept less than full billed charges if they expect payment from a PI settlement.
• Keep good records: accident reports, contact info for providers, dates of service, test results, and bills.
• Do not sign away rights to dispute bills without understanding the consequences for your settlement funds.
• If a provider threatens immediate collection, ask to speak to patient financial services and request written policies on liens and collections.
• Check whether your health insurance (if any) must be billed first; some plans have subrogation rights that affect settlement funds.