Disclaimer: This is not legal advice. This article provides general information on Missouri law and does not create an attorney-client relationship.
Detailed Answer
After an accident or injury in Missouri, healthcare providers can assert statutory liens on your settlement or judgment to cover treatment costs. Medical liens in Missouri derive from Mo. Rev. Stat. §538.225. Providers acquire a right to be paid from any proceeds you obtain in a personal injury claim. Understanding how to negotiate these liens can preserve more of your recovery. Below are key strategies.
1. Confirm Lien Validity and Amount
Start by obtaining an itemized statement. Verify that the provider followed the requirements of Mo. Rev. Stat. §538.225, including timely filing and proper notice. Review each line item for dates, services, and rates. Challenge any unbilled or duplicate entries.
2. Evaluate Usual and Customary Rates
Missouri courts often reduce liens that exceed the usual and customary charges in the area. Gather data on local Medicare, Medicaid, or private insurer rates. Argue for a reduction if the billed amount surpasses these benchmarks.
3. Leverage Comparative Fault and Policy Limits
When multiple parties share fault, the plaintiff’s net recovery may shrink. Highlight a provider’s willingness to accept a reduced lien to accelerate payment and avoid litigation costs. Emphasize any policy limits on defendant insurance to justify a pro rata reduction.
4. Pursue Statutory Reductions and Setoffs
Missouri law allows off-setting liens against collateral benefits like MedPay or PIP (Mo. Rev. Stat. §537.070). Use those offsets to insist on a proportional lien reduction.
5. Negotiate a Percentage-of-Settlement Agreement
Instead of a fixed dollar amount, some providers will accept a percentage of net recovery. Propose a sliding scale that decreases the lien percentage as the injury severity increases. This approach aligns the provider’s incentive to settle quickly.
6. Use a Lien Resolution Letter
Draft a formal lien resolution letter outlining your offer and rationale. Cite applicable statutes and case law. Set a reasonable deadline. This document encourages prompt response and signals readiness to litigate if necessary.
7. Consider Mediation or Court Intervention
If negotiations stall, file a motion with the court. Missouri courts have discretion to adjust or extinguish liens to ensure fairness. Offer mediation first to reduce costs and avoid trial delays.
Helpful Hints
- Document all communication in writing.
- Compare billed rates to local Medicare schedules.
- Secure written lien waivers when possible.
- Monitor statute of limitations for lien enforcement (Mo. Rev. Stat. §538.225).
- Engage an attorney experienced in Missouri lien resolution.