Getting medical care on a lien (letter of protection) after an injury in Louisiana

Short answer: Many personal-injury doctors and some hospitals will treat you on a lien or by accepting a letter of protection (LOP) from your attorney, but acceptance varies by provider. To find willing providers in Louisiana, pursue an attorney referral, contact trauma or orthopedic practices that regularly handle PI claims, ask hospitals about charity/LOP policies, use community health centers for urgent care needs, and always get the lien/LOP terms in writing before care begins.

Detailed answer — step-by-step guide

1. Understand what a medical lien / letter of protection (LOP) is

A medical lien or an LOP is an agreement (usually written) where a medical provider agrees to treat and defer collection of payment until you resolve your personal injury claim. The provider intends to look to any settlement, judgment, or recovery for payment. An LOP is not a guaranteed collection mechanism — the provider still has to file any claims and may have limits — and not all providers accept them.

2. Start with a personal-injury attorney

Most people who obtain care on a lien do so through an attorney who represents the injury claim. Personal-injury attorneys in Louisiana usually have existing relationships with doctors, chiropractors, imaging centers, and physical-therapy clinics that regularly accept LOPs. If you do not have an attorney yet, consider contacting the Louisiana State Bar Association referral resources for help locating a lawyer who handles personal-injury matters: https://www.lsba.org.

3. Contact providers who commonly handle PI patients

Orthopedists, spine surgeons, pain-management physicians, certain occupational-medicine clinics, and physical-therapy providers often accept LOPs because they see many personal-injury cases. Call offices and ask directly: “Do you accept treatment on a letter of protection or lien for personal-injury cases?” If yes, ask what documentation they require (attorney contact, case info, LOP language, ID, insurance info).

4. Ask hospitals about LOPs, charity care, and emergency care policies

Hospitals may be less likely than private physicians to accept an LOP, especially for inpatient stays or high-cost services. However, many will accept LOPs for outpatient specialty care or will work out delayed billing. Ask hospitals about charity care, financial assistance, and their policy for patients with pending tort claims. For state-level health resources, see the Louisiana Department of Health: https://ldh.la.gov.

5. Use community clinics and federally qualified health centers (FQHCs) for urgent access

If you cannot immediately find a provider who will accept an LOP, community health centers and FQHCs can provide low-cost or sliding-scale care to handle urgent needs until an LOP can be arranged. Use the HRSA health center finder to locate clinics: https://findahealthcenter.hrsa.gov.

6. Consider medical-lien companies or funding options carefully

Some companies offer to pay medical providers up front in exchange for receiving payment from your settlement. These companies often charge fees or interest; discuss risks and costs with your attorney before using them.

7. What to get in writing — the LOP agreement

Never rely on verbal agreements. An LOP or lien statement should be written, signed by the provider (and ideally by your attorney), and contain at least:

• Patient name and date of birth
• Provider/facility name, address, and tax ID
• Statement that the provider will defer collection and look to recovery from the injury claim
• Any caps, percentages, or agreed-upon maximums
• Instructions regarding billing of third-party insurance (if any)
• Whether the provider will accept reduced payment if the settlement is limited
• Contact information for the attorney handling the claim (if available)

8. Know the limits and competing obligations

Different obligations can affect recovery: patient health insurance (including Medicare or Medicaid) may have subrogation or conditional-payment rights that must be repaid from settlement proceeds. If you have Medicare, the Centers for Medicare & Medicaid Services (CMS) has rules about conditional payments and recovery: https://www.cms.gov. Your attorney should address these issues early.

9. Keep records and communicate

Keep copies of all LOPs, treatment notes, bills, and correspondence. Provide your attorney with treatment documentation as it accumulates. That documentation helps establish causation, damages, and the lien amount when you negotiate settlement.

Practical scripts and questions to ask a provider

When calling a provider’s office, use short, direct questions:

• “Do you accept treatment on a lien or letter of protection for personal-injury patients?”
• “What documentation do you require to treat me on an LOP?”
• “Will you place a written lien, and what is the billing procedure after settlement?”
• “Do you accept reduced payment if the case settles for less than expected?”

Common reasons providers decline LOPs

• High expected cost of upcoming care (e.g., surgery, long hospital stays)
• No attorney or lack of clear case information
• Provider policy or past bad experiences collecting under LOPs
• Patient has liens or creditors that complicate collection priority

When you can’t find a provider who accepts an LOP

If providers decline, options include:

• Ask your attorney about funding companies or litigation funding (weigh costs carefully)
• Request a payment plan or discounted self-pay rate
• Receive urgent care at community clinics while pursuing an attorney referral
• File a prompt insurance claim (if you have PIP or UM coverage) that may pay for care sooner

Helpful Hints

• Start early: the earlier you contact an attorney, the sooner you can access LOP-friendly providers.
• Bring identification and any available insurance information even if you plan to use an LOP.
• Ask for a written LOP before getting non‑emergency care; never assume the provider will accept an oral promise.
• Keep treatment reasonable and well-documented — insurers and defense counsel will scrutinize excessive care.
• Discuss Medicare/Medicaid status with your attorney immediately — federal rules can create repayment obligations.
• If you’re unsure where to start, contact the Louisiana Department of Health (ldh.la.gov) and local clinics via the HRSA finder (findahealthcenter.hrsa.gov).
• Ask your attorney to obtain signed liens or releases from each treating provider before settlement distribution to avoid later claims against proceeds.

Disclaimer: This article is educational only and does not provide legal advice. It does not create an attorney-client relationship. For advice about your specific situation, speak with a licensed Louisiana attorney who handles personal-injury cases.