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How Does Lien-Based Medical Treatment Work?

Receiving proper medical treatment after an injury is critical to your physical recovery. If you don't get the right care, the chances that your injury will persist for many months and years is significantly higher. However, with the right treatment after a bad car crash or other type of injury, your chances of a full recovery are much better. But what about the cost of getting the "right" care? Most people don't have the cash or credit to get all the treatment they need, and this applies to people with good health insurance, too. 

Some of the best medical facilities in California accept injury liens.

Some of the best medical facilities in California accept injury liens.

Lien-Based Treatment

Doctors area able to treat you and get paid later - obviously the doctor that treats you and gets a check from your health insurance has to wait a few weeks to get paid. This is one approach to the business of healthcare. Some doctors are willing to provide treatment with the expectation that they will be paid after an injury case settles. The idea is that if you were injured by someone else and there's a lawyer involved who is handling the case and expects to win, the insurance company will eventually be paying on the case. In this situation, the patient signs a lien, meaning that when the case settles, the doctor gets paid before the patient does. For example, if you are injured in a car accident and receive lien-based medical treatment, the sequence goes like this: treatment is received by you, with no out of pocket costs. Then, after your attorney wins the case, or reaches a settlement with the insurance company of the at-fault driver, the money goes into a trust account at the law firm's bank. From there, the attorney must first pay the doctor who has a lien - this contract/lien is in the attorney's file. In this way, the patient is able to get the right medical treatment, and the doctor's office is paid for its services.

Proper diagnosis matters: It isn't enough to just say you were hurt, or that your life has changed. You need the right doctor with the right training to help you reach a full recovery.

Proper diagnosis matters: It isn't enough to just say you were hurt, or that your life has changed. You need the right doctor with the right training to help you reach a full recovery.

Why Might Lien-Based Treatment Be Good for Injured Patients?

Big HMOs can be difficult to schedule appointments with, especially if your treatment requires many follow-up visits, or a consultation with a specialist. We've all had the experience of waiting for a referral to a specialist and being told that so-and-so doesn't have an open appointment for a few weeks. Well, if you need to see an orthopedic surgeon or neurosurgeon today, but you can't get in for a month, your health lays in the balance during that time. Also, the quality of care can be better with doctors who treat on a lien. Many lien-based medical offices, or doctors offices who accept traditional health insurance, as well as cash payments and lien based payments, are privately owned. These doctors are often highly specialized, meaning they are able to sustain their own businesses without the need to be part of a big HMO system or hospital. 

Because the offices tend to be privately owned, the doctors have more say in who they decide to treat, and who they decide they don't want to treat. This means they can control their schedules better, meaning your chances of getting in for an appointment are better. The payment system is also a big issue for a lot of people injured in car accidents, auto versus pedestrian injuries, and slip and fall injuries. Again, because many people don't just have thousands of dollars set aside in their bank account just in case they are injured in a car accident, most people are not ready for what can be expensive medical care after an accident.

Access to the proper specialists without having to wait months for an appointment is one reason many injured people decide to seek lien-based treatment.

Access to the proper specialists without having to wait months for an appointment is one reason many injured people decide to seek lien-based treatment.

How Does Lien Treatment Affect Your Injury Case?

The bottom line is that if you don't get proper medical treatment for your injuries, you can't expect the insurance company to take your word for it and trust you were injured. No medical treatment means no settlement money to compensate you for your loss. For example, if you were injured in a car accident, but due to financial constraints or scheduling conflicts you weren't able to get the medical care you needed, you can't just expect the at-fault driver's insurance company to take a compassionate route and pay you the same amount for your injury as if you went to the doctor. Thus, even with very bad injuries, without the documentation and proper treatment from a doctor, the insurance company will not pay fair money on your claim.

But what is "fair" money anyways? Well, consider a scenario in which two people have identical injuries from the same crash. One person goes to the doctor, sees the specialists he/she is referred to, and reaches a full recovery after a few months. The doctor's notes document the patient's injury step-by-step, from the first visit until the last. Perhaps this person's case settles for $50,000. Now consider the second person does not go to the doctor, although they have the exact same injuries. This person has nothing to "prove" he/she was injured. They may not get any settlement at all. If they do get a settlement, it will likely be around a couple hundred of dollars, known as "nuisance money." If the second person gets $500, that's a difference of $49,500! The difference is the first person sought appropriate and reasonable medical care, and their injuries are documented by a medical professional. Although the second person had identical injuries, they basically walk away with nothing. 

How Can You Find Lien-Based Treatment?

If you got hurt in a car accident, or got hit on your bicycle, or was injured and it was not your fault, you're likely going to need to see a primary care physician, or other general medical practitioner. This may be at the emergency room, or at urgent care, or at your primary care physician's office. The office may refer you to future treatment, and you can ask if they know of offices for the treatment you require who will accept lien-based care. Also, most personal injury law firms are aware of medical facilities that are willing to treat on a lien. A good injury lawyer will have handled lots of injury cases, and so he or she will have worked on files and made payments on past cases to medical offices and doctors who accept lien-based care.

Many top surgeons accept liens. This is one reason some injured clients decide to have their surgeries performed at a private medical clinic rather than at an HMO

Many top surgeons accept liens. This is one reason some injured clients decide to have their surgeries performed at a private medical clinic rather than at an HMO

What Kind of Treatment Can You Get on a Lien?

Name a kind of medical office or specialty and you can find an office that treats on a lien. In California, there are surgeons, chiropractors, MRI facilities, physical therapy offices, holistic medicine, orthopedic surgeons, pain management, podiatrists - the list is basically endless. This is not to say that every office accepts lien-based care, or even the majority. While lien-based treatment is increasingly popular, the majority of medical offices may not be comfortable with this arrangement. However, if a medical office has provided treatment and then gotten paid promptly by a good injury attorney, they are very likely to accept lien-based treatment. For this reason, a medical office may want to know the name of your attorney and the firm he or she works for. If your attorney is a general attorney who does a bit of everything, but does not focus on personal injury exclusively, it is less likely that the medical office will be willing to treat you on a lien. But, if you are represented by a law firm that focuses its entire practice on injury law, the chances that that medical office will be willing to treat you up front at no cost are much higher.

Get an Attorney With a Good Reputation

Because doctors want to work with attorneys who they know will win the case and pay the doctor's bill, it is important that you seek an attorney who has a lot of experience handling personal injury cases. Consider that with the aid of modern technology, the best attorney for handling your injury claim may not be in your town or even your county! Most law firms these days are able to do a lot of work using email, faxes, and video-chat, such that someone located in San Bernardino, for example, might be best off going with a law firm represented in Orange County or Los Angeles County. At the end of the day, you want an attorney who knows injury law backwards and forwards - the chances that you will find an attorney with that kind of experience just by happenstance that is located in your city or town may not be high. Most attorneys in California will agree that the best thing you can do is find an attorney who focuses on one type of case, and has room in his or her schedule to give your case the attention it deserves.

Still Have Questions?

The Lions Injury Lawyers, P.C. focus entirely on personal injury matters. They don't handle any other types of cases but injury claims. They accept car accident cases, auto versus pedestrian (including auto versus bicycle and skateboard), slip and fall, general negligence, products liability, failure to warn, and premises liability. The Lions are not a settlement mill - they won't just settle your case for pennies on the dollar in order to be able to handle more cases. All cases handled by The Lions are handled by an actual attorney. If you have questions about your case, including whether it is worth it to get an attorney, or whether in the end you'll get more money in your pocket by representing yourself or going with a lawyer, you should talk to a lawyer. Call The Lions and talk to a lawyer, not a salesman.  

Back to where you were before the injury - that's what the law says you're entitled to after you're hurt by someone else's negligence.

Back to where you were before the injury - that's what the law says you're entitled to after you're hurt by someone else's negligence.

Car Accident Injuries & Medical Bills: What Insurance Will (and will not) Pay

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The range of injuries that result from car accidents varies greatly, from minor scuffs and bruises, to catastrophic injuries that require extensive hospitalization, surgery, and other intense medical treatment. If you were injured in a car accident in California, the laws essentially state that you are entitled to be made whole again, or to receive the medical care necessary to bring you back to the same state of health you were in prior to the car crash. The person who hit you is responsible for paying these medical bills, in general, but there are many "loopholes" that make getting full payment of your medical bills paid for difficult or impossible. 

How Does Insurance Evaluate Medical Care?

An injured person is expected to pursue reasonable medical treatment to care for their pains and ailments. What is reasonable? The answer to that question is, of course, subjective and it depends on who you ask. Generally speaking, medical care is considered reasonable by insurance adjusters if it happens at an appropriate time in relation to the car accident, the number of visits are within a normal range, and the cost of the care is within what insurance companies define as "industry standard." Some insurance companies are more strict than others when defining a price point for industry standard, which means they will not pay for treatment over a certain dollar point, regardless of where you live or how soon after your car accident you sought medical treatment. This situation leads many injured people to seek the advice of an injury attorney, even just to review their case and get advice on how to move forward.

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The Cost of Medical Treatment

Some insurance companies look to what Medicare accepts as "normal" pricing for a medical treatment or procedure. Obviously this is the lowest number possible for any given medical care, and the average car accident victim is unlikely to receive any medical treatment at the Medicare price. Does this mean you have to shop around endlessly to find the absolute cheapest medical care to treat your injuries? No. It may mean you'll benefit from the representation of a lawyer who practices car accident law, or an injury law firm that can assist you in finding access to medical care that will get you on your way towards full health. A good lawyer will fight to make sure you get your medical bills paid for and also compensation for pain and suffering.

Sequence Matters in Medical Treatment

Another way in which medical bills are slashed or denied by insurance companies is by the insurance adjuster claiming there was a "gap in treatment," or improper sequencing of care. This means that if you are hurt, you need to get help right away, and then follow the advice of your doctor. If you're injured, you need to first see a qualified doctor, and then follow the regimine the doctor prescribes you until you are better. If you take long breaks in-between treatment, you may find it difficult or impossible to get your bills paid for due to gaps in treatment. Similarly, if you know you require surgery, for example, you can't just delay getting the surgery for months and years. At some point, and it varies case by case, the insurance company will say the surgery is not related to the initial accident, and they will deny liability to pay for the operation. Sequence matters. This means you should seek the opinion of someone able to give an assessment of your injuries or ailments, like the kind of doctor visit you might get at an emergency room, at an urgent care, or through your primary care doctor. Then, you're expected to follow the advice of the doctor. For example, if the doctor says you need 25 visits of chiropractic care, you will be expected to go to a chiropractor and receive that amount of care.

Chiropractic care can be especially tricky when seeking payment for your medical bills from the insurance company of the individual liable for the accident and your injuries. Most insurance companies will balk at paying for more than 25 visits, unless specifically prescribed by a doctor not affiliated with the chiropractor's office. After 25 visits, if you are still injured, you'll be expected to seek additional treatment, something more advanced, such as an MRI, or a visit with a pain management office, or a specialist that deals with the body part(s) you've suffered injury in. 

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Don't Accept Pennies on the Dollar for your Bills

Some people injured in a car crash or other injury that was not their fault feel helpless when the insurance adjuster offers them a couple hundred dollars to pay for large bills. Feeling helpless, they don't know what to do and accept the money, thinking something is better than nothing. This plays perfectly into the insurance companies' strategy: if you offer ten people a very small settlement, at least seven or eight of those people will either go away, or eventually accept it. Dollar for dollar, this is their best bet, and they save the most money by doing this. What the seven or eight people who accept this offer do not know is that if they're offered $500, there is likely at least a couple thousand dollars available to pay for their bills, but they don't know how to get it.

Getting to a "Fair and Reasonable" Settlement for Your Injury

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If you weren't at fault, but you were injured, you deserve compensation to pay for your bills and for your pain and suffering. While the law says you deserve this, and there are tens of thousands of cases where this happens, most people don't know how to go about getting this money, and without the assistance of an experience and trusted injury law firm, you're very unlikely to get the money you deserve for your injury. Experience matters in injury law, and the representation of a good lawyer will, in almost every case, mean the injured person walks away with more money in their pocket and their medical bills paid for, than if they try to negotiate on their own. This has nothing to do with how smart the injured person is or how good a negotiator he or she is. If you don't know what your case is worth, or how the insurance company reviews your file and comes up with a price tag, you will not be able to get to their top offer. Of course, you can threaten to sue, but insurance companies are well represented by good defense law firms, so they are not intimidated by threats of lawsuits from individuals saying they'll go it alone and file the lawsuit. An injury law firm, on the other hand, will not only file a lawsuit on the injured person's behalf, but they'll go about it the right way and will very likely increase the cost of your claim by a lot of money: a lawsuit from a plaintiff represented by a good injury lawyer will get the attention of any insurance company or insurance adjuster.

The Lions Injury Lawyers, P.C. represents injured clients throughout California. Based in Orange County, CA, The Lions practice only injury law, meaning they focus 100% of their time, energy and effort on winning money for injured people throughout California. No matter if you live in San Diego County, Orange County, Los Angeles County - or somewhere else in California, The Lions will vigorously fight for you and your case. You won't talk to a salesman if you call for a free consultation - you'll discuss your case with an actual attorney, a lawyer who may eventually represent you and help you recover from your injury. Lawyers are ready to discuss your case today, or simply answer your questions.