Detailed Answer — how lien treatment works and how to find providers in Iowa

This guide explains in plain language how medical lien arrangements and letters of protection work, who uses them, where to look in Iowa, and what to watch out for. This is educational information only and not legal advice.

What is a medical lien or a letter of protection (LOP)?

A medical provider lien or a letter of protection is a promise from a patient or the patient’s attorney that the provider will seek payment from the patient’s future settlement or court recovery instead of requiring immediate payment. In practice you will most often see:

• Letter of Protection (LOP): An attorney sends a written promise to a medical provider to protect the provider’s bill and to pay from any recovery in the case.
• Provider lien or assignment: A written agreement that gives the provider the right to be paid first (or from a portion) of the plaintiff’s recovery.

Who will agree to treat on a lien or LOP?

Common providers who may accept lien/LOP arrangements in Iowa include:

• Personal-injury friendly physicians (orthopedics, neurology, pain management).
• Chiropractors, physical therapists, and rehabilitation clinics.
• Some urgent care centers and specialty clinics that work regularly with injury attorneys.
• Medical “lien” clinics or providers that specialize in treating accident victims on liens.

Step-by-step: How to find a provider that will accept a lien/LOP in Iowa

1. Contact a personal-injury attorney right away. Attorneys who handle car crashes and other PI claims routinely have relationships with providers who treat on LOPs. Even if you don’t hire the attorney immediately, many will give you referrals or issue an LOP. If you need a referral, check the Iowa State Bar or local lawyer referral services: Iowa State Bar Association.
2. Ask hospitals or clinics what they accept. Some hospitals or larger systems will not accept informal LOPs and require payment or insurance; others (often smaller clinics or specialists) will accept them. Call the clinic’s billing/finance office and ask if they accept letters of protection, what terms they require, and whether they will put any lien in writing.
3. Search for “medical lien clinic” or “treat on lien” in your area. Many cities in Iowa have clinics or providers advertising that they treat accident victims on lien. Verify their reputation and get terms in writing.
4. Get any agreement in writing. Never rely on a verbal promise. A written LOP or lien should state who will pay the bills, whether interest or collection fees apply, and whether the provider will reduce fees if paid from a settlement. Keep a copy for your records.
5. Verify billing rates and whether they will bill your health insurance. Some providers will bill liens first and insurance second; others will bill insurance first. If your provider takes your health insurance, your insurer’s subrogation or lien rights may affect your recovery. Ask how billing and write-offs work.
6. Consider community health/charity programs if you cannot find a lien arrangement. If a provider will not accept a lien, ask about hospital financial assistance or sliding-scale clinics while you pursue legal representation. For low-income help in Iowa, see Iowa Legal Aid.

Legal timing — why you should act fast (Iowa statute of limitations)

In Iowa, a typical personal-injury claim usually must be filed within two years of the injury. That deadline is critical because if you wait too long to file, you may lose the right to any recovery and then providers on lien might not get paid. For the statute of limitations on personal-injury actions, see Iowa Code § 614.1: https://www.legis.iowa.gov/docs/code/614.1.pdf. Talk to a lawyer early to preserve your claim.

Risks and practical considerations

• Providers who accept liens may charge higher fees or refuse to reduce bills if there is no recovery. Ask whether they will discount their bills in a settlement.
• If you sign a lien or assignment, carefully read the document to see whether the provider gets paid before your attorney’s fees or costs. Clarify priorities in writing.
• If you have health insurance, your insurer may have subrogation rights and could claim part of your settlement. That affects how much remains to pay medical bills.
• Some “medical lien companies” buy and collect medical debt; if you use a lien clinic, know who actually holds the claim.
• If your case does not produce a recovery, you may be personally responsible for bills unless you agreed otherwise or the provider offers charity care.

Questions to ask any provider before accepting LOP/lien care

• Do you accept letters of protection or treat on lien for personal-injury cases?
• Will you put the lien/LOP in writing? May I review the exact language?
• Will you bill my health insurance first, or will the provider pursue payment only from a settlement?
• Do you charge interest, collection fees, or require a percentage of my settlement beyond billed charges?
• What happens if my claim is unsuccessful (no settlement or judgment)?
• Will you negotiate or reduce billed charges if needed at time of settlement?

Finding trusted help

Good places to start in Iowa:

• Iowa personal-injury attorneys and law firms (many offer free consultations and will advise or issue an LOP).
• Local clinics that advertise “treat on lien” or “letters of protection accepted.”
• Iowa Legal Aid for low-income assistance: https://www.iowalegalaid.org.
• If you need a referral to an attorney, the Iowa State Bar Association can help: https://www.iowabar.org.

Summary

To find a provider in Iowa willing to treat on a lien or LOP: contact a personal-injury attorney first, ask providers directly about LOP policies, get written agreements, confirm billing and insurance treatment, and act quickly because of deadlines like the personal-injury statute of limitations (see Iowa Code § 614.1: https://www.legis.iowa.gov/docs/code/614.1.pdf). Carefully document every agreement and ask questions about fees, priorities, and what happens if there’s no recovery.

Disclaimer: This is general information only and not legal advice. I am not a lawyer. For advice about your specific situation, speak with a licensed Iowa attorney.

Helpful Hints

• Bring a written LOP or referral from an attorney to the provider — it speeds acceptance.
• Keep clear records of all medical bills, treatment notes, and any written lien documents.
• Ask the provider for a written estimate of total expected charges and how they handle reductions from insurance or settlement.
• Get contact info for the clinic’s billing manager before treatment begins.
• If you have health insurance, notify your insurer and ask about subrogation and your responsibility for co-pays or deductibles.
• Consider getting at least one independent medical opinion if the injury or treatment plan is complex.
• Before signing anything, have an attorney review lien or assignment language to protect your settlement amounts and priorities.