FastCounsel

Disclaimer: This article is for educational purposes only. It does not constitute legal advice. Consult a qualified attorney for guidance tailored to your situation.

Detailed Answer

When a person receives medical treatment after an injury, a hospital or health insurer may assert a legal claim (lien) against any lawsuit settlement or judgment to recover treatment costs. Under Missouri law, both hospital and insurer liens follow specific rules. Below are the key steps to identify and resolve these liens before disbursing settlement funds.

1. Review Case Documents and Medical Bills
   Gather all medical billing statements, Explanation of Benefits (EOBs), and insurance correspondence. A hospital lien arises by statute in Missouri. See Mo. Rev. Stat. § 443.500. Confirm which providers treated the patient, the dates of service, and amounts billed.
2. Search Recorded Liens in County Records
   Missouri hospitals must record liens in the county Recorder of Deeds office within 90 days after the patient’s last date of treatment. See Mo. Rev. Stat. § 443.510. Search online records or visit the Recorder’s office to identify filed liens.
3. Obtain Written Lien Statements from Hospitals and Insurers
   Send a written request to the hospital billing department for a detailed lien statement showing the total amount claimed. For private insurers, request a subrogation or reimbursement statement outlining any contractual right to recover paid benefits. If the plan is governed by federal ERISA rules, federal law may affect your approach.
4. Validate Lien Amounts and Timeliness
   Check each claim for accuracy:
   • Timeliness: Was the hospital lien filed within the 90-day deadline? (Mo. Rev. Stat. § 443.510)
   • Patient Identity: Does the lien correctly name the patient and reflect dates of service?
   • Services Rendered: Do billed services correspond to documented treatment?
5. Negotiate or Dispute Lien Amounts
   If a lien amount seems excessive or includes noncovered services, you can dispute it in writing. Hospitals often allow reductions or write-offs. Use your client’s policy discounts or prompt-pay savings. Document all negotiations in writing.
6. Secure Lien Releases or Satisfaction Documents
   Before disbursing settlement funds, obtain a signed lien release or satisfaction document from each lienholder. Include the claim name, amount paid, and reference to the settlement. This step protects your client and finalizes satisfaction of the lien.
7. Allocate Settlement Funds
   Once releases are in hand, allocate the settlement: attorney fees, case costs, lien payments, and remaining client recovery. Maintain a clear accounting trail for audit and ethical compliance.

Helpful Hints

• Keep a centralized file of all billing and lien communications.
• Request itemized billing statements to verify each charge.
• Watch for federal or state healthcare programs (e.g., Medicaid) that may assert their own recovery rights.
• Confirm deadlines for disputing or challenging liens under Missouri statutes.
• Engage counsel early to manage liens efficiently and avoid settlement delays.