Personal Injury Medical Bills and Liens for Total Beginners!

As a personal injury lawyer since 1985, I have been asked by a lot of clients, "Who’s going to pay the medical bills from my accident?"

The simple answer to this question is: You are!

But like everything in the law, it’s not that simple.

In this article I’m going to give you a beginner's guide to understanding how to make sure the medical bills in your personal injury case get paid. I’ll also give you some real-life forms to help you stay organized, and a sample letter to help you better communicate with your personal injury lawyer about the medical bills in your case.

By the end of this article you will learn how to:

• Keep track of your bills so you can make sure they get paid,
• Keep your personal injury lawyer updated to make sure you don’t get stuck paying too much for the medical bills at the end of your case, and
• Keep an eye out for medical liens that might show up in your case so your personal injury lawyer can take care of them for you, instead of you having to do it yourself.

After you have been in an accident, the last thing you want to do is fight to have your medical bills paid. Your focus should be on getting better and recovering from your injuries. You probably won’t be too interested in the bills that are piling up.

So here are 3 Great Tips to make sure you stay on track and your medical bills get covered.

TIP #1: Write them down!

It’s really important to remember that just because you were in an accident doesn’t mean you don’t have to pay your medical bills. You are the one responsible for paying them because you are the one who is receiving the medical treatment. And your doctors and medical providers who are treating you don’t have any relationship with the person who caused your accident, so you are the one who is responsible for your medical bills.

Even though you are the person ultimately responsible for paying your medical bills, it is the job of your personal injury lawyer to try and get someone else to pay them. So the first thing you absolutely must do is keep track of your treatment and your bills, in great detail. If you don’t keep track of your bills, your personal injury lawyer won’t know what they are and can’t help you get them paid!

You must write down (preferably on your computer where you can keep a running list) the name of every doctor and medical provider you see for the injuries caused in your accident.

Start on day one!

Keep your list in chronological order, beginning with the very first person or place that you receive medical care. That probably means starting from the paramedics and ambulance who treated you at the scene, and then continuing to every doctor, physical therapist, chiropractor, blood lab, and every MRI or CT or x-ray center, every pharmacy, every medical equipment company, and any other person or place where you receive any care related to your accident.

Be sure you write down the name and title of every person who helps you (Dr. Steve Smith) as well as the name of the facility where you saw that person (ABC Medical Group), and any place they send you (Rite Aid Pharmacy and the XYZ Radiology Center) and be sure to write down their address, phone number and email (if applicable) for all of these places.

Your lawyer will need all of this information so he/she can order copies of all of your records and bills. If you don’t give this information to your personal injury lawyer the bills and records won’t be obtained and you may wind up paying the bills yourself.

Be sure to include the dates of each and every visit or service, and when necessary, include a little note about what they did or what treatment or service you received.

Here is an example of what your list might look like:

• Steve Smith MD (Family doctor)
  ABC Medical Group
  1100 Main Street Los Angeles, CA 90024
  (310) 884-8444 Email: smithmd@gmail.com
  Dates seen:
  March 8, 2021 (took x-rays and put a cast on my left arm)
  March 15, 2021 (second visit)
  April 3, 2021 (removed cast & put on a soft cast)
  NOTE: I made a $10 co-pay each visit and they submitted it to my Blue Cross insurance
• XYZ Radiology Center
  3103 Park Street Los Angeles, CA 90024
  (310) 218-6543 Email: xyzradiology@gmail.com
  Dates seen:
  March 10, 2021 (MRI of the spine)
  July 15, 2021 (ultrasound of my left shoulder)
  NOTE: I made a $40 co-pay each visit and they submitted it to my Blue Cross insurance
• Rite Aid Pharmacy
  2202 Main Street Los Angeles, CA 90024
  (310) 765-9876
  Pain medication picked up 3/15/21
  Arm brace picked up 3/15/21

This type of complete and specific record keeping is really important and I cannot stress how necessary it is to the success of your case. Your lawyer will need this information in order to maximize the amount of your recovery and to make sure that your medical bills are paid.

It is much easier to start your list of medical providers right at the beginning, on day one. If you try to do it later it will not be as accurate. An accurate list will allow your lawyer to check the records he/she receives with the list you provide so they can be cross-checked to make sure the records are complete.

I can’t tell you how many times I have had someone contact me at Higher Legal to help them find a new lawyer because they claimed their old lawyer didn’t submit all of their medical expenses to the insurance company. After further investigation, I would often discover the client never gave a complete list of their medical bills or providers to their lawyer, so the lawyer never knew about them!

Your medical bills won’t be paid if you don’t keep excellent track of them and submit them to your lawyer. This is your primary job as a good client and it is something important you can do to help your case.

TIP #2: Keep your lawyer updated

The next step is to keep your personal injury lawyer updated. Don’t wait too long to email your lawyer a complete list of your medical providers. Once you have started to receive your treatment and therapy, send the information about your medical providers and bills that you have been keeping in your computer to your lawyer in an email (not in a letter, not in a phone message, and not in a text).

The subject line of your email should be something like: “(Your Name): Medical Providers”. Then every time you feel you have more information, send your lawyer a new email with a subject line that reads something like: “UPDATE #1 to (Your Name) Medical Providers”. In the UPDATE emails you send to your lawyer, be sure you send EVERYTHING, meaning all of the new medical information, and all of the old information that you sent the first time. That way the update email will have all of your information, from the beginning of your treatment to the current time. This should be easy to do if you are keeping this information in a running list on your computer.

Every few months send another update to your lawyer (UPDATE #2 then UPDATE #3, etc.) and keep doing this until the end of your case. With this method of collecting information about your medical providers and treatment, nothing will be missed and all of your medical bills will be considered when your lawyer is negotiating with the insurance company in your case.

Sending your lawyer an email will also keep your lawyer's attention on your case, and your case will get more attention than it otherwise might receive.

It’s all about teamwork

It’s important that you have the email address of your personal injury lawyer. If you don’t have it, get it! Email is the best way for you to communicate with your personal injury lawyer. It makes an accurate record of what was said and when it was said, and it's a lot less wordy than a phone call. Email helps everyone get right to the point, without a lot of small talk!

Since you are going to be emailing your list of medical providers and expenses to your lawyer, you should also try to get the email address of your lawyer's paralegal, or law clerk, or secretary, or other people in the office who are working on your case so you can copy your emails to each of them. Your case is a team effort and if everyone on the team knows what is going on, the better it is for you and your case!

When you email your lawyer and the team working on your case to provide information about your medical expenses and providers, be sure to include something in your email like this:

“Please let me know if you have ordered copies of my medical records and bills. I would like to get a copy of them from you so I can also review them to make sure they are accurate and complete.”

An email like this will let your lawyer know you are both serious about and interested in your case. It will also make sure your lawyer is ordering your records. When you get a copy of your medical records and bills from your lawyer (it should be a PDF, not a paper copy) you should look them over carefully to make sure they are accurate and complete. You can do this by comparing them with the list of providers you have been keeping on your computer.

Also, when you email your lawyer, always be sure to send your lawyer a copy of any bills, or insurance EOBs (Explanation of Benefits), or any other insurance documents you have received at home in the mail, including anything like a Notice of Collection.

The best way to send documents to your lawyer is to scan the documents and attach them to your email as a PDF. If you don’t own a scanner, you can go to FedEx Office or your local library to scan them. This is much better than sending them by regular mail because they will be easier for your lawyer to access and store in your client file. Don’t take a picture of the documents with your phone and send the photo to your lawyer because the quality of those documents is usually terrible and of no value. Be sure not to write on the documents because your lawyer will need to submit these to the insurance company to settle your case and only clean documents should be submitted. And don’t send your original bills or paperwork to your lawyer. If they get lost, you will have a problem. Scan them and email them, that’s the best practice.

It’s a slow process, so be patient

One more thing I want to mention here is just because you are periodically sending your lawyer an update of your treatment, doesn’t mean that you will be receiving periodic checks for your medical bills. You won’t, so you need to make sure your bills are being paid (possibly by your health insurance company or your auto policy med pay).

Be sure to ask your lawyer what you should do about any outstanding medical bills.

If you have unpaid medical bills make sure your health providers are willing to wait for their payment until your case is over (by taking a lien). You want to make sure your bills are being paid, or that your healthcare providers will wait for payment, otherwise you may be thrown into collection, and that is terrible for your credit score. Your lawyer can help you with this, so be sure to ask your lawyer.

In personal injury cases, the insurance company for the person or entity that caused your injuries will not make piecemeal payments. That would be an accounting nightmare for them. Instead, they will make one lump sum payment at the end of your case. So they will not pay your medical bills as you go and therefore it's important that you and your personal injury lawyer take care of contacting your medical providers.

TIP #3: Lookout for Liens

One of the reasons it is so important for you to keep good records and email all of your medical information to your lawyer is because it will help your lawyer identify any possible liens in your case. It’s imperative to take care of all liens in your case or you may be caught taking care of them on your own after your case is over.

What is a lien?

In a nutshell, a lien is created by a contract or a law that requires you to pay some of the money from your personal injury case to someone else, such as a hospital, doctor, insurance company, or government agency. The lien says it’s your responsibility to “pay them back” for money they paid on your behalf. That’s why it is so important for your lawyer to identify all the possible liens in your case before your case is resolved, because if they don’t, you may have to pay those liens on your own after your case is over.

Sometimes liens are created by a contract you have signed which says you agree to pay back or reimburse someone like your health insurance company or a hospital for money they paid for your treatment. Sometimes liens are created by the law, like the requirement to pay back Medi-Cal when they pay for your treatment.

No matter what type of liens apply to your personal injury case, you need the help of your personal injury lawyer to make sure all of the liens in your case are (1) identified and then (2) negotiated by your lawyer. This is extremely important in your case! If the liens are not identified and paid at the end of your case, you may owe the money yourself.

The issue of liens in personal injury cases is very complicated and way too complicated to explain in a single blog post. (I have another post about that) What I want to do in this article is simply put you on notice that you need to identify all possible liens in your case so you can make sure your lawyer identifies and resolves them prior to the completion of your case.

Here are a few types of common liens that might apply to your case that you should look out for and ask your attorney about:

Hospital, doctor, and medical liens

Almost all injury cases have some type of medical lien from a doctor or hospital.

I recommend to my clients at Higher Legal that they send their lawyer an email (not in a letter, not a phone message, and not in a text) and ask their lawyer to identify and resolve any and all liens in their case. This puts the lawyer on notice that you expect them to take care of this important issue before the case is over. The email should be sent shortly after you send your lawyer the first email which contains the names, addresses, dates of your medical providers. The subject line on this email might be something like “[Your Name] - Liens” and the email might ask something like this:

Sample email to your lawyer

Dear Attorney Smith:
I understand there may be a number of contractual or statutory liens in my case. I want to make sure that all liens in my case are identified and that you have time to negotiate them before my case is settled or otherwise resolved. I sent you a list of the medical providers on [put date of your prior email here] and if there is any additional information you need from me to identify any liens, please let me know. I will continue to send you updates of my medical providers as I continue my treatment.

Thank you for the work you are doing on my case!

Warm regards,
Mrs. Client

As mentioned above, it is critically important for your lawyer to obtain all of your hospital, doctor, and medical records and bills so (1) they can be used to maximize the settlement value of your case, and (2) so any possible liens can be identified.

In addition to identifying all liens, it is also the job of your lawyer to scrutinize the charges being asserted by the hospital and medical providers to determine if they were “related and necessary” to treat the injuries caused in your accident. For example, if your hospital is claiming a lien on your case of $2,000 but you identify that $500 of it was for an eye exam that had nothing to do with your accident, the hospital can’t try to get that money out of your case because it is not related to the injuries in your case. Your lawyer will also review your medical records and bills to challenge the “reasonableness” of the bills and make sure the charges are not excessive.

Health insurance liens

If you have health insurance, your health insurance policy contains a provision that says you will pay your health insurance company back if they pay for medical expenses that were incurred as a result of someone else’s negligence.

Here’s a simple example of how that works. Let's say you are in a car accident and you have to go to the doctor and receive physical therapy and the bills for your medical care total $5,000. If your health insurance company pays the $5,000 to the doctor and physical therapist, and then you file a personal injury claim against the person who caused the accident and they pay you $15,000 to settle your claim, your health insurance company will want their $5,000 back and they may assert a lien on your case to get reimbursement. Your lawyer will contact your health insurance company and will negotiate with them so that you will not have to pay back the full $5,000.

Medi-Cal and Medicare Liens

These are known as “super liens'' and in California, your personal injury attorney is obligated to check with these entities to determine if benefits have been paid for you due to treatment needed as a result of your accident. When these entities are involved in a case, there is usually some delay after the settlement of your case for these agencies to carefully check to verify what benefits have been paid out on your behalf. The delay could be weeks, months, or more, so be sure your lawyer gets right on it.

Medicare is a federally funded program and will only pay a portion of your bills, if applicable. Doctors and hospitals who accept Medicare payments are entitled to bill you for the unpaid part of their bills, so again, this is very complicated and it is important for your lawyer to identify all liens and negotiate them before your case is completed.

Medi-Cal is a California state-funded program and also only pays a portion of your medical bills. Doctors and hospitals who accept Medi-Cal payments are NOT entitled to bill you for the unpaid part of their bills. Whatever state you live in, be sure to ask your personal injury lawyer about any program that may apply to your case that needs to be notified.

Make sure your lawyer checks for all possible liens that might apply to your case, including healthcare provider liens, healthcare insurance company liens, government agencies and programs, and workers compensation carriers.

Here is a shortlist of some of the most common liens:

Medicare
Medi-Cal
Medicaid
Hospital Lien Act (California)
Veteran’s Administration

It is standard practice in personal injury cases for your lawyer to identify and to take care of (negotiate and resolve) any and all liens in your case. This is something you are paying your lawyer to do and it takes a high level of expertise. It's not something you can easily do on your own, so make sure your lawyer knows about all of the liens that apply to your case and then negotiates the best deal for you on them. You’re paying your lawyer to do this! The better your personal injury lawyer does in negotiating down your liens, the more money that will end up in your pocket.

I hope this article has provided you with some helpful information on how to make sure your medical bills get paid when you are in an accident.

I also realize there is a lot of information to absorb here, and this is only a very short summary of these very complex issues, so if you have any questions, please always feel free to reach out to me at Higher Legal: Tell Me About Your Case

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If you want me to get right back to you, the best and the fastest way to reach me and to get a response is through a message on the Higher Legal website.

During my legal career, I worked with some of the very best personal injury lawyers in California who recovered billions of dollars for people injured in accidents and represented thousands of people who have been injured in all sorts of accidents. I have access to a lot of useful information and I hope to share my knowledge and experience with you through the Higher Legal blogs and YouTube videos. My hope is to help you navigate the world of personal injury law.

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