Disclaimer: This article is for educational purposes only. It does not constitute legal advice. Consult a qualified attorney to address your specific situation.
Detailed Answer
In South Dakota, hospitals enjoy a statutory lien for medical services provided to an injured person under SDCL Chapter 36-11 (see SDCL 36-11-1 et seq.). Physicians, however, generally do not hold a statutory lien under South Dakota law. Instead, a doctor’s right to payment arises from contract terms or equitable lien principles recognized by the courts.
Because physicians lack a statutory priority lien, they often negotiate their outstanding bills when a personal injury settlement is imminent. You can approach your physician’s office (or billing department) and propose a reduced lump-sum payment. Common negotiation strategies include:
- Pointing to Medicare or Medicaid fee schedules as benchmarks.
- Arguing that a substantial reduction ensures prompt payment.
- Requesting a customary percentage of billed charges (often 40%–60%).
Insurance companies and defense counsel typically want to clear all liens before issuing settlement checks. Your personal injury attorney can coordinate the process, ensuring each provider signs a lien waiver or release once you pay the negotiated amount.
Key Steps to Negotiate Your Physician’s Bill:
- Obtain itemized billing statements.
- Compare charges to usual and customary rates or Medicare fee schedules.
- Submit a written proposal to the provider’s billing office.
- Get any agreement in writing, including a full release of lien rights upon payment.
- Coordinate final disbursement through your attorney.
Because physicians rely on contract and equitable lien rights rather than statute, they often have greater flexibility to reduce their bills. By negotiating effectively, you can maximize your net recovery and resolve all medical obligations before closing your personal injury case.
Helpful Hints
- Always demand an itemized bill to spot duplicate or unrelated charges.
- Use Medicare fee schedules as a benchmark for reasonable fees.
- Insist on a written settlement and lien waiver before sending payment.
- Prioritize statutory liens (e.g., hospital liens under SDCL Chapter 36-11) before negotiating physician balances.
- Engage your personal injury attorney early to manage all medical lien negotiations.
- Keep detailed records of all communications and agreements.