Medical liens allow hospitals and certain providers to secure payment from your personal injury settlement or verdict. In Texas, healthcare facilities and physicians may file liens under Tex. Health & Safety Code Chapter 273 to recover unpaid treatment costs. You can negotiate these liens to reduce your liability and boost your net recovery.
Detailed Answer
Under Texas law, a hospital or physician submits an affidavit and itemized bill to the county clerk within 180 days of the patient’s last treatment to perfect a lien (Tex. Health & Safety Code §273.001). Once perfected, the lien attaches to any settlement, judgment or award in a related third-party claim.
Follow these strategies to negotiate down liens:
- Audit and verify charges. Request a detailed, itemized statement of services, dates and CPT codes. Confirm each charge matches your medical records.
- Compare to benchmark rates. Use Medicare fee schedules or usual, customary and reasonable (UCR) rates to identify inflated fees. Many providers accept a reduction to these standard rates.
- Challenge necessity and reasonableness. Question any treatment that seems excessive, duplicated or unrelated to your injury. Providers often agree to write off questionable expenses.
- Offer lump-sum settlements. Present an all-inclusive proposal for a percentage of billed charges. Many providers accept 30–50% of the total bill if paid in full promptly.
- Negotiate payment plans. If you cannot pay a lump sum, ask for a structured payment plan at a reduced total. Providers may prefer guaranteed recovery over collection risk.
- Leverage timelines. Identify statutory deadlines for lien enforcement. If a provider misses the 180-day filing window, the lien may become unenforceable.
- Use a medical billing advocate. Engage a professional who specializes in audits and negotiations. They often secure deeper discounts.
- Coordinate with opposing counsel. In some cases, defense attorneys may withhold lien amounts in escrow until resolution and negotiate directly with providers.
By reducing your total lien exposure, you free more settlement funds for your non-medical damages. Always document each offer and agreement in writing.
Helpful Hints
- Keep all medical bills organized and request itemized statements early.
- Track filing dates for all liens to spot missed deadlines.
- Involve your personal injury attorney before settlement talks begin.
- Consult the fee schedules of Medicare and other payors for benchmarks.
- Be prepared to negotiate face-to-face or by phone with billing managers.
- Get any negotiated reduction in writing and include it in settlement documents.
- Review Tex. Health & Safety Code Chapter 273 for your provider’s lien rights (Chapter 273).
Disclaimer: This article is for informational purposes only and does not constitute legal advice.