Short answer

If you were injured and expect to pursue a personal injury claim, some New Hampshire doctors, clinics, and hospitals will treat you now and accept payment later through a written arrangement such as a medical lien or a Letter of Protection (LOP). These arrangements vary by provider. To find providers who will accept a lien or LOP you should: (1) contact personal injury attorneys for referrals, (2) call local hospitals and clinics and ask about lien policies, and (3) be ready to provide documentation, sign a written agreement, and understand the financial and legal risks before you sign.

Detailed answer: what a medical lien or Letter of Protection is and how it works in New Hampshire

Definitions and basic mechanics

• Letter of Protection (LOP): A written promise from your personal injury attorney to a medical provider to protect the provider’s right to payment from any future recovery in your claim. The provider agrees not to bill you personally while the claim is pending and to look to the case recovery for payment.
• Medical lien or assignment: A written lien or assignment gives the medical provider a legal claim against the proceeds of a personal injury settlement or judgment. The exact wording and enforceability depend on the agreement and applicable law.

General operation

1. You get medical care now. The provider agrees to defer billing or to accept payment from the eventual recovery.
2. The provider often requires a signed document (LOP, lien, or assignment) spelling out rights and limits.
3. When you obtain a settlement or judgment, the lien or LOP typically entitles the provider to be paid from those proceeds before you receive money.

Key things to know under New Hampshire practice

• New Hampshire providers commonly accept LOPs and liens in personal injury matters, but acceptance is voluntary. Each provider sets its own policy.
• A provider’s right to enforce a lien or LOP depends on the written agreement, the facts, and New Hampshire law and court practice. Because court decisions and procedures matter, providers sometimes prefer to work through an attorney.
• If you sign an LOP or lien, carefully read the document. Some agreements include interest, collection fees, or carve-outs for Medicaid/Medicare—know how those will affect your recovery.

How to find providers who will treat you on a lien/LOP in New Hampshire

1. Contact a personal injury attorney for referrals and an LOP: Many providers accept LOPs only when an attorney issues the LOP. If you cannot afford an attorney up front, look for personal injury attorneys who take cases on contingency and will issue an LOP. Use the New Hampshire Bar Association Lawyer Referral Service (https://www.nhbar.org/) to find attorneys who handle PI matters.
2. Call hospitals and medical groups: Ask the billing or trauma coordinator whether they accept LOPs or medical liens for personal injury cases. Larger hospitals sometimes have formal policies; smaller clinics may be flexible.
3. Contact specialty providers who see injury cases: Orthopedists, pain management practices, physical therapy clinics, and chiropractors frequently accept LOPs. Ask each clinic’s billing office about their lien policy and what paperwork they require.
4. Visit community health centers and urgent care clinics: Federally funded community health centers have sliding-fee schedules and may help even if they do not accept liens. Urgent care centers sometimes work with LOPs; ask directly.
5. Speak with your insurance company: If you have health insurance, providers may bill your carrier first. That can preserve your relationship with the provider while the claim moves forward. Know any subrogation rights insurance may assert against a recovery.
6. Ask for a written agreement and get a copy: Never accept a verbal promise. A clear written LOP or lien should state what is owed, any interest or fees, and how payments will be taken from a settlement or judgment.

What to ask before signing an LOP or lien

• Exactly what charges are covered by the LOP?
• Will the provider accept partial payment if your settlement is limited?
• Are interest, collection, or attorney’s fees added to the balance?
• How does the agreement interact with health insurance, Medicaid, Medicare, or other liens?
• What happens if you never recover money in your personal injury case?
• Does the provider intend to enforce a statutory or equitable lien, or only collect by agreement?

Documentation you should have ready

• Photo ID and contact information.
• Insurance information (health, auto, or other relevant policies).
• Police, incident, or crash reports (if available).
• Photographs of injuries or property damage.
• Any written LOP or lien forms the provider or attorney gives you.

Practical tips and risks

• Signing an LOP can let you get timely medical care when you lack funds. However, it may reduce the money you receive from a settlement because medical bills are paid from recovery funds.
• Providers sometimes negotiate reductions or write-offs once a case resolves. Ask if the provider routinely discounts balances paid from settlements.
• If you receive public benefits (Medicaid, Medicare), those programs may have rights to repayment from your settlement. Coordinate with counsel so you understand subrogation obligations.
• If you do not hire an attorney and the provider expects payment from a recovery, you may have to manage notices and payoff negotiations yourself. This can be complex; consider at least a consultation with a personal injury lawyer.

Resources

• New Hampshire Revised Statutes and other laws: general access to the RSA codified laws is available at the New Hampshire General Court website: https://www.gencourt.state.nh.us/rsa/html/
• New Hampshire Bar Association/Lawyer Referral Service: https://www.nhbar.org/
• New Hampshire Department of Health and Human Services: https://www.dhhs.nh.gov/

Helpful Hints

• Start by calling the billing office—ask for the phrase “do you accept Letters of Protection or medical liens for personal injury claims?”
• If you can, get a brief consult with a PI attorney who will issue an LOP. Many attorneys offer free intake and take PI cases on contingency.
• Keep all medical records and bills organized in one folder or electronic file for your attorney and providers.
• Ask the provider to include any discounts or write-offs they agree to in writing before you sign.
• Tell providers about any public benefits you receive so they can explain how those benefits affect their lien rights.
• Don’t sign a document that seems to give up your right to challenge unreasonable charges or that purports to waive your right to legal counsel.
• If a provider threatens immediate collection while your case is ongoing, seek legal help—an attorney can often resolve or negotiate hold-offs.