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Disclaimer: This information is for educational purposes only and does not constitute legal advice. Consult a qualified attorney about your specific situation.

Detailed Answer

In Washington, medical providers and health care facilities may assert liens against personal injury recoveries for treatment rendered under RCW 7.70.065. To finalize your settlement or judgment and distribute proceeds to you, you must satisfy or resolve these liens first. Below is a step-by-step outline of that process:

1. Identify All Lien Holders: Gather all notices of lien from hospitals, physicians, therapists, and any subrogation claims by health insurers. Keep track of both private providers and government payers (e.g., Medicare or Medicaid).
2. Confirm Lien Validity: Under RCW 7.70.065, providers must file a notice of lien with the clerk of the court and serve it on all parties. Verify the lien filing date, patient name, billing details, and statutory compliance.
3. Review and Dispute Charges: Examine billing statements and explanation of benefits. Challenge any bills that exceed usual and customary rates or include noncovered services. Accurate medical coding and billing audits can help reduce inflated charges.
4. Negotiate Reductions: Many providers and insurers will accept a discounted payoff. Common reductions range from 30% to 60% of the billed amount. Submit written settlement offers or demand letters to each lienholder.
5. Set Aside Funds in Escrow: Your attorney or settlement agent should segregate sufficient funds from the gross recovery to cover negotiated lien amounts, attorneys’ fees, and case costs. This prevents distribution delays and disputes.
6. Pay and Satisfy Liens: Once you reach agreement, issue payment checks directly to the lienholders. After payment, request a lien release form or a signed satisfaction of lien statement.
7. File Lien Releases with the Court: Under RCW 7.70.065(6), file each satisfaction of lien with the court clerk and serve copies on all parties. This officially discharges the lien, clears title to your recovery, and allows the court to approve final distribution.
8. Resolve Federal Subrogation: If Medicare or an ERISA plan covered your expenses, federal law (42 U.S.C. § 1395y(b)) may impose additional notice and conditional payment procedures. Notify the Centers for Medicare & Medicaid Services (CMS) and submit a conditional payment letter to avoid future repayment claims.
9. Obtain Final Court Approval and Distribute Funds: With all liens satisfied and releases on file, the court can approve disbursement of net proceeds to you. Ensure your attorney accounts for any unpaid costs or residual liens before releasing funds.

Helpful Hints

• Start lien identification early to prevent last-minute settlement hiccups.
• Maintain an organized file of all lien correspondence and payment records.
• Negotiate firmly; many providers will accept substantially less than billed.
• Track filing deadlines: most providers must file liens within 60 days after you notify them of the lawsuit (RCW 7.70.065(2)).
• Discuss how liens affect your attorney fee—most fee agreements are based on net recovery after lien payments.
• Address federal subrogation (Medicare/ERISA) promptly to avoid future claw-back actions.
• Work with a personal injury attorney experienced in Washington lien law to streamline the process.