Author: John R. Alexander

In April 2007, our Advocate article was “Should health care providers make medical liens part of their billing practices?” The following is the “cookbook” recipe for establishing in your office procedures for the regular filing of effective medical liens.

1. When conducting the “intake” of a new patient who claims injury by another person, be certain to learn the name of the “at-fault” party, the name of the at-fault party’s liability insurer (the “third party insurer”) and the claim number assigned to the matter by the third party insurer. ¹
2. Maintain a master list of patients who are making claims for compensation with the insurer for the at-fault party. On this master list, record the name of the patient, the date of injury, the name of the third party insurer, the claim number, the date the lien was filed with the county auditor, the date the patient balance was paid, and the date the satisfaction of lien was issued by your office.
3. Separate from the patient chart, maintain with your book keeping records for each injury patient, a file for the maintenance of copies and correspondence related to the medical lien filed for that patient’s bills.
4. Collect and in an organized fashion maintain the information and forms necessary for your office staff to quickly and easily issue and file medical liens and to write correspondence related to the liens.
   
   This would include a “lien information” sheet upon which would be recorded the name of the patient, the name of the at-fault party, the names, addresses, phone numbers, and claim numbers of the insurance companies to whom notice of the lien and copy of the lien will be provided, and the date the lien was filed and re-filed.
   
   Using your word processing system, create “merge” forms for the quick and easy issuance of liens and related correspondence. These forms will include:
   

   A) A Notice of Claim of Lien for Medical Services. This is the legal document completed and filed with the County Auditor. Conformed copies² of the lien should be mailed to the patient, to the patient’s attorney, the patient’s insurance company, and most important of all, to the third party insurer.
   
   B) Form cover letters for the mailing of the conformed copies of the lien to the parties stated in the foregoing paragraph.
   
   C) Form letters for requesting updates from the patient’s attorney and from the third party insurer as to when the medical bills will be paid and the lien satisfied.
   
   D) A list of the addresses and contact information for the auditor’s offices for all of the counties of Washington state. (The medical lien is filed with the county auditor of the county in which the health care services were provided.)
   
   E) Copies of the lien statutes: Revised Code of Washington (RCW) 60.44 et seq.for your own knowledge
   
   F) A Release and Satisfaction of Claim of Lien. This is the form filed with the auditor’s office when the medical bills have been paid and the lien has been “satisfied.”

   Twice yearly, Adler Giersch, PS offers one day seminars for providers and their billing staff entitled, Effectively Managing your Personal Injury Claims, at which these forms are provided, in addition to a wealth of information and guidance on the maximizing of provider relations with insurance companies.
   
   Exemplars copies of the aforementioned documents can also be had by contacting Adler Giersch, PS.
5. A “tickler” system must be set-up for the regular review of the lien payment status and the status of the lien. A medical lien has a life of only one year and must be renewed to remain effective until such time as the lien is satisfied with full payment of the treatment bills. Should a lien expire, it is not too late to file the lien again, provided payment of the settlement or judgment proceeds have not yet been paid by the third party insurer.

Be reminded that a “promise to pay” letter signed by the attorney is not a guarantee of payment, nor is it a “lien.” Well-functioning lien filing procedures in the billing departments of treatment providers provide confidence and leverage to the accounts receivable personnel in the collecting of treatment costs.

Finally, the assurance of the payment of provider balances in personal injury matters can rest with the patient’s advocate who has a reputation for ensuring their client’s healthcare expenses are paid in full at the conclusion of a claim. The attorneys of Adler Giersch, PS have always committed themselves to the principal of the providing its clients with the highest degree of legal representation with integrity and ensuring that their financial obligations to their health care providers are satisfied at the conclusion of their claim.

1. If the patient does know the name and claim number of the third party insurance company, provided the patient has reported the loss to his/her own insurance company, the patient’s insurance company will know the name and claim number of the third party insurer.

2. A conformed copy of a lien is a copy after it has been signed and after such stamps and received markings have been placed upon it by the particular county’s auditor’s office. Conformed copies of the lien filed with the auditor’s office should be requested and a self-addressed and stamped envelope enclosed with your lien for filing, for return of the conformed copy.