Medical liens: Assignments and Authorizations
The term “medical lien” is used to mean a lot of different things. In this context, I’m using it to describe medical liens that are created when doctors require patients (and sometimes accident lawyers) to sign a promise to pay the bill at time of settlement of their case. Another phrase for this is assignment and authorization (A&A). (You can find information on medical liens from health insurance companies here.)
More Settlement Information
While it creates occasional hassles and problems for our lawyers, the idea behind these medical liens is often a good one. Doctors often will accept a medical lien, which then makes them willing to withhold collection of their bill or treat the patient while holding off on collection of those medical bill for that treatment. Some patients are not going to find treatment any other way.
Assignment and Authorization: What It Does
The medial lien document is a contract whereby the doctor agrees to treat or withhold collection on medical bills in exchange for a promise by the injury victim to compensate the doctor for the doctor’s bills out of any personal injury settlement or recovery at trial. Within the document itself, the client typically instructs the lawyer – irrevocably – to pay the doctor’s bill first before disbursing compensation to the accident victim client. The doctor often wants the patient's car accident lawyer to acknowledge the lien either by signing the lien or at least by letter.
Will your doctor provide treatment in exchange for a medical lien? There are three answers: (1) yes, (2) no, and (3) it depends on the injuries or the accident lawyers involved. Many accident lawyers know doctors who will accept liens and refer their clients to those doctors. Sometimes, our lawyers are forced to do this, too.
Patients Should Find There Own Doctors in Perfect World
Still, we prefer that patients find their own doctors? Why? Are the doctors we send clients to see bad doctors? No, that is not the problem. We prefer that our clients find their own doctors because doctors referred by lawyers are easier to cross examine at trial. All things being equal - a big disclaimer - insurance companies are usually going to pay more for the same injuries and same treatment from doctors that are found "organically" by the patient through their own sources (at least that is our opinion).
It is also important to keep in mind that the lien does not make the doctors’ bills contingent on a recovery. If the case is lost, many accident lawyers do not charge fees or expenses, but the medical bills are still owed as they would be if there was no accident case at all.
Keep in mind that these are general rules that may vary from state-to-state. You will want to speak to an accident lawyer who knows the law in your jurisdiction.