Getting Medical Care on a Lien (Letter of Protection) in New Jersey: A Practical FAQ

Disclaimer: This is general information and not legal advice. Consult a licensed New Jersey attorney for advice about your specific situation.

Detailed answer — how treatment-on-lien works and how to find providers in New Jersey

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

A medical lien or letter of protection (LOP) is an agreement between you, a treating medical provider, and often your personal-injury attorney. The provider agrees to delay billing you personally and instead seeks payment from the settlement, judgment, or recovery you obtain from the person or insurer responsible for your injuries. The LOP protects the provider’s interest in your eventual recovery and lets you get treatment when you lack the funds upfront.

Is this allowed in New Jersey?

Providers frequently use LOPs in New Jersey for care tied to personal-injury claims. The rules governing liens and recovery can be technical, and local practice varies by provider. Because LOPs create contractual obligations between provider and patient (or patient’s attorney), providers and attorneys commonly rely on written LOPs and careful documentation.

Step-by-step: How to find a doctor or facility that will treat on a lien

1. Talk to a personal-injury attorney first. Attorneys who handle personal-injury cases commonly maintain lists of doctors, imaging centers, physical therapists, and specialists who accept LOPs. If you plan to use a lien, an attorney can prepare the LOP correctly and contact providers on your behalf.
2. Search for providers who advertise “accept LOP,” “medical lien,” or “treat on a lien.” Use search terms such as “medical lien New Jersey,” “letter of protection NJ,” “treat on lien NJ,” plus your county or city. Many orthopedists, pain-management clinics, chiropractors, and physical-therapy centers list this service on their websites.
3. Call the provider’s billing department before an appointment. Ask whether they accept LOPs, what documentation they require (a written LOP from an attorney, patient information, case details), and whether they will file a lien or expect the attorney to do so. Get these answers in writing when possible (email confirmation).
4. If you don’t yet have an attorney, ask if the provider will accept a patient-signed LOP or partial payments. Some providers will accept an LOP without an attorney but may require partial deposits or proof of a pending claim. Others will insist on an attorney’s involvement before treating on lien.
5. Check hospitals and emergency departments carefully. Emergency rooms must treat emergencies regardless of payment arrangements, but many hospitals and ERs bill immediately and do not routinely accept LOPs for non-life-threatening follow-up care. For ongoing specialty treatment, ask whether the hospital’s physician groups or affiliated specialists accept LOPs.
6. Consider community health centers and charity care. If you cannot find a provider willing to take a lien, community clinics, federally qualified health centers (FQHCs), or hospital charity programs may be able to provide care on a sliding scale or for free while your claim proceeds.
7. Get the LOP in writing and keep all records. A valid written LOP should identify the patient, the provider, the attorney or claimant, the nature of the claim, and the promise that the provider will be paid from recovery. Keep copies of all bills, records, communications, and the signed LOP.

What providers typically accept LOPs?

In New Jersey, common provider types that accept LOPs include:

• Orthopedic surgeons and sports-medicine clinics
• Pain-management specialists
• Chiropractors
• Physical therapy clinics
• Diagnostic imaging centers (MRI, CT)
• Some urgent-care and specialty clinics

What providers usually will not accept a lien?

Many hospitals, emergency departments, primary-care offices, and certain specialists may not accept LOPs for routine billing. Hospitals often have complex billing rules and may require immediate payment or insurance information. Always ask the specific provider about their policy.

What providers require before they agree to treat you on lien

• A written Letter of Protection from an attorney, or an agreement signed by you promising payment from any recovery
• Case information: how the injury happened, the responsible party, insurer if any, and attorney contact information
• Sometimes a signed medical-records release so the provider can communicate with your attorney
• Occasionally a deposit or agreement to make partial payments if the provider is uncertain about collectability

Timing and statute of limitations—why prompt action matters

Delays in filing a personal-injury claim can affect your ability to recover and therefore affect a provider’s willingness to accept a lien. New Jersey has time limits for bringing personal-injury claims. Missing the deadline can prevent recovery and make a lien unenforceable. If you have been injured, start the process and talk to an attorney promptly. For general reference to New Jersey’s personal-injury time limits, see the New Jersey Legislature’s statutes at https://www.njleg.state.nj.us/.

How providers get paid from your recovery

When a case settles or you obtain a judgment, the provider’s lien or LOP typically requires the settlement to pay outstanding medical bills before you receive the net recovery. The exact mechanics depend on the LOP language, agreements among your attorney and providers, and case negotiations. Some disputes over the reasonableness of medical charges can arise and may require negotiation or court resolution.

What if a provider tries to bill you personally later?

If a provider accepted an LOP or agreed to a lien but later seeks payment directly, first review the LOP and any written communications. Contact your attorney immediately. If you don’t have an attorney, request written confirmation of the original agreement from the provider and consider consulting a New Jersey consumer or personal-injury lawyer to protect your interests.

Helpful hints

• Get a written LOP from a licensed New Jersey attorney whenever possible. Providers prefer attorney-signed LOPs.
• Keep detailed records: all medical bills, invoices, appointment notes, and copies of the LOP.
• Ask providers in advance about the specific LOP language they accept and whether they will file a lien or rely on the attorney to do so.
• Be upfront about your injury claim status—who the insurer is (if any), who is at fault, and whether you have retained counsel.
• Call multiple providers. Policies vary widely even within the same specialty or hospital system.
• If you can’t find a willing provider, contact local legal-aid clinics, community health centers, or county health departments for alternatives.
• Understand that an LOP does not create a statutory right to payment in all circumstances—collection depends on your recovery and the enforceability of the agreement.
• Act quickly. Personal-injury cases have deadlines; delays can harm your claim and the prospects for lien-based treatment.

If you want help finding an attorney who handles lien arrangements or a list of New Jersey providers that commonly accept LOPs, consider contacting a local personal-injury attorney for a consultation. They can explain how LOPs work in your county and may refer you to trusted medical providers.

Remember: this information is educational and not legal advice. Speak with a New Jersey attorney about your particular facts and options.