Q: Does a hospital have a legitimate lien if their claim was rejected by my health insurance because they waited too long?
I was treated in an emergency room for injuries from an accident that was the fault of the other driver. I provided my health insurance card at the time of my treatment. 3 months after treatment, the hospital made a claim against my auto insurance medpay, but after ~$2K of payment to the hospital (which maxed out my medpay at that point), the hospital still had a claim of $16+K, which, 3 months after that, they filed with my health insurance. My health insurance rejected it since it was so late after the date of treatment (over 6 months). 7 months after that I received a lien letter from a company representing the hospital. I never received a bill from the hospital at any time. I am looking to write my own demand letter. Does the hospital still have a legitimate claim to any proceeds I obtain in my settlement?
A: Most likely the hospital will have a Lien on your settlement monies. It really depends on the specific laws of your state. Hospital lien laws are very powerful here in my state of Colorado. You would have to look at the hospital lien statute and laws governing that statute in your state.
A: This is a common problem we see with hospitals in Colorado. Hospitals prefer billing Med Pay because they receive more than if only health insurance was used. A problem arises, as in your case, where there is a remaining balance after Med Pay has been received. Fortunately, Colorado recently has passed a law requiring a hospital to bill health insurance before it can assert a valid lien. We are typically able to resolve these disputes by communicating directly with the health insurance carrier and the hospital's billing department. In our experience, the health insurance carrier often becomes the patient's best ally in resolving the outstanding balance. Although each case is different, when a hospital fails to follow billing practices for a health insurance carrier (and a patient covered under that carrier's health plan), it can lead to the hospital writing off the remaining portion. Please feel free to reach out to us with any specific questions.
Justia Ask a Lawyer is a forum for consumers to get answers to basic legal questions. Any information sent through Justia Ask a Lawyer is not secure and is done so on a non-confidential basis only.
The use of this website to ask questions or receive answers does not create an attorney–client relationship between you and Justia, or between you and any attorney who receives your information or responds to your questions, nor is it intended to create such a relationship. Additionally, no responses on this forum constitute legal advice, which must be tailored to the specific circumstances of each case. You should not act upon information provided in Justia Ask a Lawyer without seeking professional counsel from an attorney admitted or authorized to practice in your jurisdiction. Justia assumes no responsibility to any person who relies on information contained on or received through this site and disclaims all liability in respect to such information.
Justia cannot guarantee that the information on this website (including any legal information provided by an attorney through this service) is accurate, complete, or up-to-date. While we intend to make every attempt to keep the information on this site current, the owners of and contributors to this site make no claims, promises or guarantees about the accuracy, completeness or adequacy of the information contained in or linked to from this site.