Detailed Answer

“Treatment on a lien” usually means a medical provider agrees to delay billing you personally and instead seek payment from a future recovery in your personal injury claim. In practice this most commonly happens through a written agreement called a letter of protection (LOP) or through a provider’s claim or lien against any settlement or judgment. In New Mexico, whether a provider will accept treatment on such terms is a business decision made by the provider. There is no universal mandatory rule that forces every clinic or doctor to accept a lien arrangement; some hospitals and specialty clinics may have statutory lien rights in certain circumstances, while most independent physicians or clinics accept an LOP as a private contract.

How this typically works

• Client is injured and needs care but cannot pay up front.
• Client either already has a personal injury attorney or seeks one; an attorney issues a letter of protection to the medical provider promising payment from the client’s recovery (settlement or judgment) after costs and attorney fees are paid.
• Provider agrees to treat under that LOP and to defer collection efforts until the case resolves; the provider may require a signed agreement and may record a lien or assignment if permitted.
• At settlement or judgment the provider is paid from the recovery according to the LOP or lien agreement; if there is no recovery, the provider may pursue collection against the patient unless the provider’s agreement says otherwise.

What to expect from providers in New Mexico

• Most providers who accept LOPs will want a written LOP from your attorney that includes case details, the attorney’s contact information, and an agreement to protect the provider’s right to payment from the settlement.
• Different providers have different policies: emergency departments and trauma centers often treat regardless of ability to pay, but large hospitals may insist on payment or may file statutory liens where allowed; smaller clinics, chiropractors, and some specialists commonly accept LOPs.
• Providers may require you to sign an agreement assigning or placing a lien on any recovery. Read it carefully and consult your attorney before signing.
• If you receive Medicaid or Medicare, special federal and state rules about subrogation and reimbursement apply. Providers must follow those rules; recovery funds may be used to repay public benefits.

Important New Mexico resources

• New Mexico Legislature — statutes and searchable database: https://www.nmlegis.gov/ (search terms: “lien,” “hospital lien,” or “assignment”).
• New Mexico Human Services Department (Medicaid rules and recovery/subrogation info): https://www.hsd.state.nm.us/
• New Mexico State Bar — lawyer referral and resources: https://www.sbnm.org/

Practical steps to find a provider who will treat on lien or under an LOP

1. Talk with a personal injury attorney right away. Attorneys routinely have lists of doctors, clinics, and specialists who accept LOPs and will issue letters of protection. If you cannot afford an attorney, use the State Bar referral service to find one who offers a free consultation.
2. Ask the attorney for a written letter of protection or LOP. Many providers will not start or continue care without an LOP in writing. The LOP should identify the provider, the case, the attorney, and that payment will come from the recovery.
3. Contact medical providers’ billing departments. Call hospitals, urgent care centers, orthopedic clinics, pain-management specialists, chiropractors, and rehabilitation clinics. Ask if they accept LOPs for P.I. cases and what documentation they need.
4. Search for “treat on lien” or “medical lien” online locally. Some communities have medical providers who advertise lien or LOP acceptance for personal injury clients. Search with your city or county + “medical lien” or “letter of protection.”
5. Consider community health centers and trauma hospitals. They will ensure treatment first; billing arrangements can sometimes be negotiated later if you have a pending claim.
6. Get everything in writing. Before treatment, obtain copies of any LOP, lien agreement, or assignment. Confirm whether the provider will place a lien on the settlement or simply agree to be paid from proceeds.

Common questions providers will ask

• Do you have an attorney? (If so, provider will contact the attorney for an LOP.)
• What is the nature of the injury and anticipated treatment?
• Is there insurance involved (auto, liability) and who is the insurer?
• Will you sign a contract assigning recovery rights to the provider?

How providers are paid at settlement

When a case settles or you obtain a judgment, the attorney typically arranges for providers to be paid from the recovered funds. Providers may negotiate to accept a reduced amount or place a lien against the recovery. If public benefits (Medicaid/Medicare) were used, federal/state reimbursement rules often require some repayment from your recovery; coordinate with your attorney and the public benefits agency.

Risks and red flags

• No written LOP or lien agreement — always get the agreement in writing.
• Provider demands up-front large payment despite promising a lien — ask for clear terms and consult your attorney.
• Provider refuses to coordinate with your attorney — red flag if they will not confirm lien status or intended collection method.
• Unlicensed providers or entities offering unrealistic guarantees — verify licensing and credentials with New Mexico Boards.

If you are unsure whether a provider’s lien or assignment language is fair, have your attorney review it before signing. If you do not yet have an attorney, use the State Bar referral service to get a consultation so an attorney can draft or approve an appropriate LOP.

Helpful Hints

• Bring clear, dated records of your injury and any police/accident reports when talking to a provider.
• Ask providers for their billing contact and insurance coordinator — these staff handle lien/LOP questions frequently.
• Request the provider’s written policy for treatment under an LOP (what portion of the recovery they will seek, whether they will accept reductions, and who will be billed if there is no recovery).
• Keep copies of all LOPs, liens, and signed agreements. Save emails and correspondence between your attorney and providers.
• Be transparent about public benefits (Medicaid/Medicare) — providers must follow subrogation rules and failing to disclose may cause complications later.
• If you have urgent care needs, get emergency treatment first. LOPs and liens can typically be arranged afterward for ongoing care.
• Ask your attorney to negotiate and, where appropriate, reduce provider balances at settlement—many providers accept reduced payment rather than risk full nonpayment if a case fails.