Disclaimer: This article is for general informational purposes only and does not constitute legal advice. Consult a licensed attorney to discuss your specific situation.
Detailed Answer
Overview of Medical Liens in New Mexico
When you suffer injuries due to someone else’s negligence and receive medical treatment, health care providers may file a lien against your personal injury settlement or judgment. New Mexico’s medical lien statute, NMSA 1978 § 41-5-15, grants providers the right to secure payment directly from your case proceeds (NMSA 1978 § 41-5-15).
Key Negotiation Strategies
1. Verify Lien Validity and Amount
Review the lien document for accuracy. Confirm the provider’s name, treatment dates and itemized charges. Ensure they complied with notice deadlines under New Mexico law. If the lien lacks proper notice or breaks statutory requirements, you may have leverage to reduce or invalidate it.
2. Obtain an Itemized Bill
Request a detailed bill showing CPT codes, dates of service and units billed. This transparency helps you identify duplicate charges, excessive rates or nonessential treatments. You can negotiate out-of-pocket allowances more effectively when you know exactly what services you’re paying for.
3. Compare to Usual and Customary Rates
Use regional fee schedules—such as Medicare or New Mexico’s Medicaid rates—to benchmark costs. If the provider’s billed rates exceed these benchmarks, present comparative data. Providers often reduce liens when confronted with published, lower fee schedules.
4. Leverage Contingency Fee Agreements
Explain that your attorney’s fee hinges on settlement net of medical liens. A high lien balance leaves you little to recover after legal fees. Providers often negotiate down when they see a risk of zero recovery if they rigidly hold full balance.
5. Negotiate a Percentage Reduction
Providers frequently accept a percentage of the billed amount—commonly 30%–60%—in full satisfaction. Propose realistic figures based on the case size, treatment necessity and overall settlement value.
6. Challenge Unnecessary or Non-Related Treatments
Focus on treatments not directly related to the injury. If the provider billed for services outside the scope of your accident-related care, dispute those line items. Providers often concede when their claim has weak causal links.
7. Use a Structured Settlement Approach
Offer to structure lien payments over time instead of a lump sum. Smaller monthly payments can be more palatable to providers and increase your bargaining power.
8. Determine Provider’s Business Status
Some providers—especially physician groups—sell liens to third-party finance companies at a discount. Negotiating directly with a lien buyer may yield deeper reductions than the original provider.
When to Seek Legal Help
If negotiations stall or the provider threatens foreclosure, enlist an attorney experienced in New Mexico personal injury and lien disputes. They can draft formal objections, file motions to dispute lien validity or negotiate on your behalf.
Helpful Hints
- Gather all treatment records and bills early. Early preparation strengthens your negotiating position.
- Use publicly available fee schedules (Medicare, Medicaid) to benchmark rates.
- Keep a clear record of all communications with the provider and lien holders.
- Ask about early-pay discounts—some providers lower balances for prompt payment.
- Consider splitting disputed amounts: pay uncontested charges and negotiate the rest.
- Review your attorney’s contingency fee agreement for lien negotiation clauses.
- Consult an attorney if the lien exceeds 50% of your settlement estimate.