Disclaimer: This article does not provide legal advice. Consult a Utah-licensed attorney for guidance.
Detailed Answer
Under Utah Code § 38-9-3, health care providers can place a lien on a patient’s settlement or verdict to secure payment for medical services. Medical liens attach to any claim or cause of action against a third party who owes damages for personal injury. To maximize recovery and minimize liens, use these strategies:
1. Verify Lien Perfection
Ensure the provider filed the lien within 180 days after the last date of service and properly served all parties. If they failed, request a court order to extinguish the lien under Utah Code § 38-9-3(1).
2. Audit and Challenge Charges
Request an itemized billing statement. Look for duplicate entries, unbundled services, or charges for non-incident-related treatments. Compare billed fees with local usual and customary rates using databases like FAIR Health or Medicare fee schedules. Challenge any inflated or unrelated charges in writing.
3. Leverage Insurance Adjustments
Most providers must accept the amount allowed by the insurance payor as full payment. If your client’s insurer negotiated a reduced rate, the lien is limited to that net amount. Provide the provider with Explanation of Benefits (EOBs) and ask them to reduce the lien accordingly.
4. Negotiate a Lump-Sum Settlement
Propose paying a percentage of the billed amount in exchange for a lien release. Providers often accept 30–50% as a one-time payment to avoid litigation and collection costs. Get any agreement in writing and record a lien release upon payment.
5. Consider Litigation and Enforcement Costs
Court action to enforce or dispute a lien under Utah Code § 38-9-5 can delay resolution and increase costs for providers. Use this leverage to negotiate a lower balance.
Helpful Hints
- Track all deadlines for lien filing and service.
- Keep organized records of medical bills, itemized statements, and EOBs.
- Use online fee databases to benchmark reasonable medical costs.
- Document all communications with lienholders in writing.
- Engage counsel early if the provider refuses reasonable reduction.