Disclaimer: This is general information, not legal advice. Laws change and every case is different. Consult a licensed Tennessee attorney before making decisions about a settlement or paying liens.
Detailed answer: How a claimant in Tennessee identifies and resolves medical liens on a personal injury settlement
When you settle a personal injury claim, health care providers, health plans, and government programs (like Medicare or TennCare) can assert liens, subrogation claims, or demands for repayment. Follow these steps to identify and properly resolve those claims so you can safely disburse settlement funds.
1. Collect facts and documents about the injury and payments
- Gather every medical bill, explanation of benefits (EOB), medical record, and receipts for treatment tied to the accident.
- Collect your settlement documents (demand letters, releases, and correspondence), insurance policy information for all potentially responsible carriers, and any documents from treating providers that reference a lien or balance.
2. Identify potential lien claimants
- Medical providers that treated you (hospitals, clinics, physicians, ambulance services, durable medical equipment vendors).
- Your private health insurers or ERISA plans (they may have subrogation rights).
- Medicare and TennCare (Medicaid) may assert repayment or conditional payment claims.
- Any collection agencies or law firms who have recorded liens or filed suit to collect.
3. Search for recorded liens and statutory lien rights in Tennessee
- Ask billing departments and the hospital’s business office whether a lien was filed and request a copy of the lien statement.
- Search the county records (where the provider is located) for recorded liens or judgment liens.
- Know Tennessee’s hospital-lien law. See Tenn. Code Ann. § 29-2-101 et seq. for hospital liens and enforcement procedures: https://www.capitol.tn.gov/legislation/laws/29-2-101.html (hospital lien statute).
4. Identify government-program claims (Medicare and TennCare)
- If you are Medicare-eligible, contact Medicare’s recovery contractor or use the Medicare Conditional Payment portal to request an official conditional payment amount. CMS requires identification and resolution of conditional payments under federal law: https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview and https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Recoveries.
- If you received TennCare (Tennessee’s Medicaid), TennCare may have a right to be reimbursed from your settlement. State rules and the TennCare recovery unit handle those claims.
5. Send written lien verification requests
- For each provider or insurer asserting a lien or balance, request: (a) the written basis of the lien or claim, (b) itemized bills, (c) proof the provider billed your health insurer (if any), (d) any assignment or lien documents, and (e) supporting medical records showing treatment related to the accident.
- Keep copies and track dates. If a claimant can’t substantiate a lien, you may dispute or demand it be released.
6. Evaluate the validity and priority of each claim
- Hospital statutory liens (when valid and properly filed) may have priority under Tennessee law; review the statute and any filing requirements and deadlines: https://www.capitol.tn.gov/legislation/laws/29-2-101.html.
- Private insurers and ERISA plans typically assert subrogation rather than a statutory lien; their rights often depend on plan documents, payments made, and whether you signed an agreement promising to repay out of recovery.
- Medicare/TennCare claims are governed by federal and state recovery rules (Medicare’s repayment rules are mandatory and can supersede private reductions unless properly resolved with CMS).
7. Negotiate reductions where possible
- Medical providers often accept reduced payoffs (common practice is to negotiate aggressively, and many providers will accept a percentage of billed charges).
- Private insurers and ERISA plans may be willing to compromise; ask for a written settlement or release showing the reduced amount and that the lien or subrogation claim is satisfied.
- Try to obtain a written, signed release or lien-waiver that specifically states the claimant will not pursue repayment from settlement proceeds.
8. Protect settlement proceeds before paying anyone
- Do not disburse funds until liens and repayment demands are resolved in writing.
- If you must settle quickly, consider placing the disputed portion of the settlement into an escrow account or court registry while you resolve claims.
- If a hospital lien is asserted and you negotiate a compromise, get a formal release of the lien recorded where the lien was filed.
9. Resolve Medicare/TennCare conditional-payment demands
- Request a final conditional payment amount from Medicare and resolve CMS’s claim before disbursing funds. CMS has detailed procedures and timelines: https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Recoveries.
- TennCare may also seek reimbursement. Contact TennCare’s recovery unit for an official demand and follow their process for compromise or payment.
10. Obtain written releases and close the file
- Obtain signed release documents from each party whose lien you paid or whose claim you compromised. The release should reference the claim, the settlement, and that the lien or subrogation interest is fully satisfied.
- Record lien releases where original liens were recorded (county records) if required by statute.
- Keep a full file with all correspondence, payoff checks, escrow confirmations, and releases in case a claimant resurfaces.
11. When to get legal help
- Hire a Tennessee personal-injury attorney or a lawyer experienced with subrogation and lien resolution if: liens are numerous or large, Medicare/TennCare is involved, providers threaten lawsuit, or a provider claims a statutory lien that could disrupt your settlement.
- An attorney can negotiate, escrow funds, obtain court approval for disbursements, and contest invalid liens. They can also protect exempt portions of a recovery (like pain-and-suffering) from subrogation where appropriate.
Key Tennessee statute and federal resources
- Tennessee hospital lien statute: Tenn. Code Ann. § 29-2-101 et seq. (hospital lien rules and enforcement): https://www.capitol.tn.gov/legislation/laws/29-2-101.html
- Medicare coordination of benefits and recovery information (federal): https://www.cms.gov/Medicare/Coordination-of-Benefits-and-Recovery/Coordination-of-Benefits-and-Recovery-Overview
- Medicaid third-party liability and recovery (federal overview): https://www.medicaid.gov/medicaid/finance/third-party-liability/index.html
Helpful Hints
- Document everything in writing. Oral promises are hard to enforce.
- Don’t sign away your right to challenge a lien without understanding what you give up.
- Ask providers for itemized bills and proof they billed insurance; overbilling and duplicate billing happen.
- Medicare may require repayment even if a private insurer took a large share of the settlement — resolve Medicare early.
- If an ERISA plan asserts subrogation, their procedures and plan documents matter; federal ERISA rules can limit state-law arguments, so get counsel.
- Consider using escrow or a court-approved distribution order if multiple claims remain unresolved at settlement.
- Keep at least one copy of every release, bill, demand letter, and payoff check for your records — claims can recur years later.
- If you have questions about TennCare repayment, contact TennCare’s estate/recovery unit to get an official demand and resolution instructions.
Resolving medical liens can be a detailed, document-driven process. Careful identification, written verification, negotiation, and documented releases will protect your settlement and reduce the risk of later claims. For help tailored to your situation, consult a Tennessee attorney familiar with health-care lien and subrogation law.