Resolving liens effectively is critical in protecting your client’s net recovery when settling personal injury cases. Lien identification, verification, and audit are critical steps in ensuring that all potential claims are addressed and safeguarding your client’s net settlement. Here’s how to tackle these crucial processes.
Lien Identification Process
It all stars with the initial case assessment at intake. Start by gathering detailed information about healthcare providers, insurers, and other potential lienholders, including government programs (Medicare, Medicaid), private health insurance, and workers’ compensation. Collect and review all medical documentation to identify entities that may assert a lien.
Next, post intake you should obtain copies of health insurance policies and any insurance company correspondence to understand coverage and subrogation claims. Request itemized statements from healthcare providers to identify potential lien charges. Use the Medicare Secondary Payer Recovery Portal (MSPRP) and state Medicaid offices to identify any liens being asserted by government benefit programs. Verify potential liens with private insurers using Explanation of Benefits (EOB) statements. Identify any liens from ERISA plans, FEHBA plans, military healthcare providers, and workers’ compensation carriers.
Lien Verification Process
Start with confirming potential lienholder claims. Contact all potential lienholders to confirm lien existence and amounts. Obtain formal lien documentation, including detailed billing statements and legal notices. Match lienholder claims with client medical records to verify accuracy. Review insurance policy provisions or plan documents to confirm lienholder rights to recovery.
Lien Audit
Once you have completed the verification process, next up is auditing claims made by lienholders. Best practices are to organize all gathered information into a comprehensive lien spreadsheet or database. Establish criteria for the audit, such as accuracy of claimed amounts, compliance with legal requirements, relatedness and consistency with the client’s injuries.
In performing the audit, identify discrepancies or unsupported claims. Ensure all claims adhere to state and federal laws, including notification and filing requirements. Address any discrepancies with lienholders, providing supporting evidence.
Documentation/Record-Keeping & Client Communication
As part of your resolution process, you should have a policy on maintaining Records. Keep a detailed lien log and archive all correspondence with lienholders. Regularly update clients on lien status and any negotiations or disputes.
Conclusion
Implementing effective processes for lien identification, verification, and audit is essential for ensuring good lien resolution practice. A structured approach reduces the risk of future claims, enhances client satisfaction, and protects your firm from potential costly mistakes.
For a more detailed guide on a comprehensive process download our white paper titled “Comprehensive Processes for Managing Lien Resolution: Identification, Verification, and Audit” by clicking HERE. If you are ready to work with an expert lien partner, contact Synergy today for a CONSULTATION about outsourcing lien resolution.
Written by: Jason D. Lazarus, J.D., LL.M., MSCC | CEO
