Quick answer (plain language)

When you settle a Wisconsin personal injury claim, anyone who paid or provided medical care and anyone who paid your medical bills through an insurance program (private insurer, Medicare, Medicaid/Medical Assistance, or a workers’ comp carrier) can try to recover from your settlement. The verification and clearance process typically includes identifying potential claimants, asking for itemized payoff statements or subrogation demands, verifying those amounts against your records, negotiating reductions, and getting written releases or lien waivers before settlement funds are distributed. That process usually takes a few weeks for private-payor statements but can take several months for government payors (Medicaid/Medicare). In some cases it can take longer if disputes require litigation or administrative appeals.

Types of medical liens and claims you may face in Wisconsin

• Provider liens or provider “claims” — hospitals, clinics, doctors, or other providers may assert a lien or demand payment if you assigned your rights or if they have statutory lien rights under local law or contract.
• Private health insurer subrogation — an insurer that paid your medical bills may have a contractual right to be reimbursed from your recovery.
• Medicare (federal) — Medicare can seek repayment for conditional payments made for treatment related to your injury.
• Wisconsin Medical Assistance (Medicaid) / state claims — the state may assert a claim to recover benefits it paid. The Wisconsin Department of Health Services administers these programs.
• Workers’ compensation liens — if a workers’ comp plan covered your care, it may have priority or a lien for payments made.

Step-by-step process to verify and clear medical liens in Wisconsin

1. Identify all possible payors and claimants

Start by collecting all medical records, bills, Explanation of Benefits (EOBs), and correspondence. Ask your attorney or insurer for their subrogation and lien files. Typical parties to contact:

• All medical providers you saw for the injury
• Private health insurers and ERISA plan administrators
• Medicare (if you’re a beneficiary)
• Wisconsin Medical Assistance (Medicaid) or related state agencies
• Workers’ compensation carrier (if applicable)

2. Request written payoff or subrogation statements

Send written requests for itemized payoff statements. For each claimant ask for:

• Itemized bills showing dates of service and CPT/diagnosis codes
• Payments already made or adjustments taken (including contractual write-offs)
• A formal payoff or demand letter showing how the demanded amount was calculated
• Any lien documentation or assignment of rights

3. Verify charges and legal basis

Compare provider statements to your medical records and EOBs. Key verification steps:

• Confirm each billed service relates to the injury covered by your claim.
• Confirm whether a contractual discount or write-down already reduced billed charges (providers often bill inflated amounts but accept lower insurer payments).
• Check insurer subrogation language in your insurance contract — some plans limit recovery or apply a pro rata reduction for attorney fees and costs.

4. Negotiate reductions

Most providers and insurers expect negotiation. Negotiation strategies commonly used in Wisconsin cases include:

• Pointing out contractual write-offs or the provider’s usual/ customary rates
• Asserting that attorney fees and costs should reduce an insurer’s recovery under equitable principles or relevant contract terms
• Using settlement timing (offer immediate payment in exchange for a lower payoff)

5. Get written releases, lien waivers, or conditional payoff letters before distribution

Do not disburse settlement funds until you have written proof that each claimant will accept a specified payoff in full satisfaction of its claim. Typical documents include:

• Paid-in-full receipts or lien releases from providers
• Formal subrogation waivers from private insurers
• Conditional payment letters or demand letters from Medicare/CMS showing the amount owed
• State agency payoff letters or release documents for Medical Assistance claims

6. Use escrow when necessary

If a claimant will not give a release before funds are distributed, your attorney may request that the disputed portion be escrowed pending resolution. Escrow protects the claimant’s rights while letting you receive the undisputed portion of your recovery.

Who has priority and who actually gets paid first?

Priority depends on the type of claimant: federal Medicare liens usually have statutory primacy for conditional payments; state Medical Assistance claims may have statutory recovery rights; workers’ compensation liens also have statutory mechanisms. Private insurers’ rights depend mostly on contract language and, for ERISA plans, federal preemption and ERISA rules. Because priority varies, attorneys often negotiate a single global resolution for all payors so the settlement can be finalized in one step.

Typical timing — how long will verification and clearance take?

• Private providers and insurers: 2–8 weeks is common for obtaining payoff letters, but negotiations can add time.
• Medicare (federal): Getting a conditional payment amount from Medicare’s contractors (or the Medicare Secondary Payer recovery process) can take 1–3 months or longer depending on workload and whether you must request a conditional payment or submit a final demand. Plan ahead; don’t assume this is instant.
• Wisconsin Medical Assistance (Medicaid/state): State agency claims may require formal notices and administrative steps; resolution can take several months. In some cases the state will issue a lien or file a claim that requires negotiation or an administrative process.
• If litigation or disputes arise: If a provider sues to enforce a lien or a payor refuses negotiation, resolution may take many months and could require court hearings.

Overall: simple cases often clear in a few weeks. Complex cases involving multiple government payors or disputed liabilities commonly take several months. Start early and plan for delays, especially when Medicare or Medicaid are involved.

Practical tips and helpful hints

• Keep every medical bill, EOB, and records packet organized and share it with your attorney early.
• Ask for itemized bills and formal payoff letters in writing—verbal promises are risky.
• Don’t sign a full settlement release until you have written confirmation that identified liens will be satisfied or escrowed.
• Expect providers to bill the full charge but accept a far lower pay-off; always confirm what was already written off.
• If Medicare is involved, obtain a conditional payment letter from CMS before finalizing the settlement; follow the CMS process to avoid future recovery demands. For general Medicare guidance see https://www.cms.gov/ (search “MSPRP” or Medicare Secondary Payer recovery for the current process).
• Contact the Wisconsin Department of Health Services for questions about Medical Assistance recovery practices: https://www.dhs.wisconsin.gov/
• Consider using an attorney experienced with lien resolution—attorneys routinely negotiate substantial reductions that are hard for individuals to obtain alone.
• If a claimant refuses to negotiate and threatens suit, consider escrow or a declaratory judgment action — your attorney can advise on the safest path to distribution.
• Allow additional time if your case involves ERISA benefits, Medicare, or the Wisconsin Medical Assistance program—these often require extra administrative steps.