Detailed answer — step-by-step guide for Connecticut claimants

1. Start immediately: compile a medical and billing list

From the moment you retain an attorney (or decide to pursue a claim yourself), make a list of every provider and organization that treated you or billed for your care: hospitals, emergency departments, urgent care centers, physicians, imaging centers, physical therapists, ambulance services, labs, and any other specialists. Include private health insurers and government payors (Medicare or Medicaid).

2. Obtain medical records and itemized bills

Request complete medical records and itemized bills from every provider. Itemized bills show dates of service, CPT codes, and exact charges — necessary to understand who might have a lien or subrogation claim. Give each provider a signed medical authorization so your attorney can discuss bills and balances directly.

3. Identify insurance and government payors with subrogation or reimbursement rights

Tell your health insurer (including ER “balance billing” and MedPay) and any government payor (Medicare/Medicaid) about your claim. Insurers commonly have subrogation or reimbursement rights to recover payments made for treatment related to another party’s negligence. Federal programs like Medicare and Medicaid have strict recovery rules that often require repayment from settlements.

Resources: Connecticut General Assembly (to research state law) — https://www.cga.ct.gov; Medicare/Medicaid information — https://www.cms.gov; Connecticut Department of Social Services (Medicaid) — https://portal.ct.gov/DSS

4. Watch for hospital or provider lien notices

Some Connecticut hospitals and other providers may assert lien rights or file notices to protect their position. If you receive a written lien, preserve it. If you do not receive anything, a provider or insurer can still assert a reimbursement claim later — so you must proactively obtain written statements of outstanding balances and any asserted lien rights.

5. Demand verification and itemized accounting

For each asserted lien or subrogation demand, request a written statement showing: the amount claimed, how it relates to specific treatment for the injury, whether payments were reduced by contract or write-offs, and copies of billing and payment histories. Verify that the lien relates only to the injury at issue and not to unrelated care.

6. Analyze priority and offsets

Not all claims have equal priority. For example: payments by a liability insurer might be subject to different offsets than Medicare liens. Also, many providers accept discounted rates from your insurer; a correct calculation must respect contractual write-offs. Your attorney should confirm whether the claimed balance is the provider’s gross charge or the true outstanding balance after contractual adjustments.

7. Negotiate reductions and obtain written releases

Medical providers and insurers often will accept less than the full billed amount in exchange for prompt payment. Common negotiation strategies include:

• Offer a lump-sum reduction to resolve the claim.
• Request an itemized audit if charges look inflated or unrelated.
• Ask private insurers to apply their contractual write-offs and document the net balance.
• For Medicare/Medicaid, coordinate with the appropriate agency to determine the required repayment (federal law governs Medicare conditional payment recovery procedures).

Always get any settlement, reduction agreement, or release in writing. A signed lien release or a written subrogation agreement is the primary document you need before paying out settlement proceeds.

8. Protect settlement proceeds during resolution

If lien resolution is incomplete at the time of settlement, protect yourself and the other parties by doing one or more of the following:

• Allocate the settlement among damages categories (medical, lost wages, pain and suffering). Insurers and payors may accept allocations that reduce the amount they can claim.
• Create a holdback or escrow for disputed lien amounts until the lien is resolved.
• Obtain a covenant not to execute or a court order approving distribution if the case was litigated and a judge can supervise disbursement.

9. Pay liens from settlement and obtain releases

Once amounts are agreed or determined, pay lien holders from settlement proceeds as required by contract, subrogation law, or court order. Get a written lien release for any paid claim and retain it with your case file. If a payor refuses to release or continues to assert a claim, document communications and consider escrow or court intervention.

10. When to consider court intervention

If a lien holder refuses to provide reasonable verification, insists on an inflated amount, or threatens enforcement despite proof of reduction or payment, you may need a court order determining priorities or directing disbursement. Connecticut civil courts can resolve competing claims to settlement funds in appropriate cases.

11. Work with an attorney experienced in lien resolution

Handling medical liens requires attention to federal programs (Medicare/Medicaid), contract law with private insurers, and state practice. An attorney can obtain releases, negotiate reductions, arrange escrow, and, if needed, seek court orders. If you have no attorney, at least obtain written confirmations and keep meticulous documentation; but strongly consider legal help when government payors or large hospital systems are involved.

Hypothetical example

Maria is injured in a car crash in Hartford. She receives ER care, imaging, and outpatient physical therapy. Her private insurer paid part of the bills but the hospital sends a lien claim for $25,000 (gross charges). Maria’s attorney obtains itemized bills and the insurer’s Explanation of Benefits showing contractual write-offs and that Maria’s insurer paid $6,000. The hospital agrees to a negotiated payoff of $4,500 in exchange for a release. Medicare is not involved. Maria’s settlement of $40,000 is allocated: $12,000 medical, $8,000 lost wages, $20,000 pain and suffering. The attorney pays the hospital $4,500 from the medical allocation after securing a written release, sends a subrogation payoff to the insurer for $3,000, and disburses the remaining funds to Maria. If the hospital had refused to reduce, the attorney would have escrowed a disputed amount and asked the court to determine priority.

Helpful Hints

• Act early. Many lien issues become harder after settlement funds leave escrow.
• Get written authorizations so your lawyer can communicate directly with providers and insurers.
• Always request itemized bills and payment histories — gross charges are rarely the correct amount owed.
• Do not sign a full-release of defendants until you secure lien releases or protect funds for unresolved claims.
• Check for government payors (Medicare/Medicaid). They have mandatory repayment processes and timelines.
• Keep all lien releases, payoff letters, and correspondence with your settlement file forever — future disputes sometimes arise years later.
• If you cannot afford counsel, look for legal aid clinics or bar association referral services in Connecticut to help with lien negotiation.
• Use official resources to research laws or procedures: Connecticut General Assembly — https://www.cga.ct.gov; Connecticut Judicial Branch — https://www.jud.ct.gov; Connecticut Department of Social Services (Medicaid) — https://portal.ct.gov/DSS; Medicare/Medicaid recovery info — https://www.cms.gov