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Lien Resolution

Lien resolution that reads each lienholder’s itemized list against the client’s injuries, cites each cut, and shows the settlement falling from gross to net.

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The problem

A settlement waits in trust while each lien list is read line by line

The case settles and the money lands in the trust account. Before any of it reaches the client, the lien specialist has to find each party that paid for her care. That means Medicare, Medicaid, the plan she had through work, the hospital that filed a lien and the therapist who treated on a letter of protection, each with its own list.

Those lists carry care the crash had nothing to do with: a diabetes visit, a screening mammogram, an eye exam, a shoulder hurt years earlier. Finding them means reading line after line against the medical chronology. Each payer’s reduction rule turns on facts in the plan document or the settlement, and while letters go back and forth the client calls to ask where her money is. Miss one Medicare conditional payment and the lawyer is personally exposed, with interest running and double damages at the end.

Built forLien specialistsSettlement attorneysSettlement coordinatorsManaging partners

The Problem Today

When a case settles, everyone who paid for the client’s care wants it back, often for care the crash never caused.

$250,000
paid by one firm over unreimbursed Medicare payments published
60 days
to pay Medicare’s final demand before interest runs published

Done by hand today

  • Lienholders
  • Line items
  • Statutes
  • Letters
  • The lawyer is exposedMedicare can collect double from whoever held the money
  • The client waitsMoney sits in trust while letters go back and forth

The Solution

  1. Lienholders foundBills, plan cards and the Medicare check; the rest ruled out in writing
  2. Unrelated care struckEach billed line checked against the injuries, with the record page
  3. The statutes appliedProcurement cost and made-whole, each with its source and arithmetic
  4. One lien total, signedThe attorney signs; only then can another person disburse

Built-in controls

  • No strike without the specialist’s approval
  • Disbursement needs a second person
  • Health records kept out of model training

What You Get

The client keeps more of her settlement, and each dollar paid to a lienholder is one the firm can defend.

46%
off the claimed liens on the worked case, each cut cited our estimate
  • Final demands trackedThe attorney is alerted well before a demand falls due
  • Medicare’s share held in trustReleased only when its final demand arrives
  • Letters ready to signDisputes and reductions, each figure tied to its source
The lien file

Lien resolution on one settled injury case, from trust deposit to payout

Each feature is one screen, set in the order lien work runs, with the role that relies on it.

  1. 01Cases waiting on lien release

    A queue of settled cases, each with its money in trust and its hold-up named

    How it works

    • 11 settled cases waiting on lien release, $3,640,000 in trust between them
    • A bar per case runs from gross to net: fee and costs, liens negotiated, liens still challenged
    • Each row names the next deadline and the one thing blocking release
    • Filter to the cases that need attention or the ones ready to pay out

    Lien resolution specialistSees which settled client has waited longest and why, without opening eleven files.

  2. 02Lien register and lienholder search

    A lienholder search that rules payers out in writing as well as in

    How it works

    • Reads bills, explanations of benefits, plan cards and the Medicare beneficiary check
    • 214 bills and benefit statements read, 9 payers named on them
    • 5 lienholders with a claim; auto medical payments, veterans’ care and workers’ compensation ruled out with evidence
    • The register beside it holds each lien’s basis, claim, challenge and deadline

    Lien resolution specialistCan show the attorney why three payers owe nothing back, before a missed one turns up after the money has gone.

  3. 03Charge audit, Medicare

    A charge audit that flags Medicare lines the crash did not cause

    How it works

    • Matches each of 27 billed lines to the chronology by date, diagnosis code and body part
    • Injuries from the crash sit beside the conditions on record before it
    • Marks each line related or unrelated, with its reason and record page
    • 9 lines flagged: $1,450 of unrelated care leaves $46,750 of related care

    Lien resolution specialistStops paying Medicare back for a diabetes visit, a flu shot and a cataract evaluation, without reading each billed line against the chronology herself.

  4. 04Chronology page from a citation

    The record page behind a proposed strike, one click from the charge

    How it works

    • Each reason carries a citation to a page of the medical chronology
    • Clicking it opens that page with the diagnosis marked
    • The $418.90 echocardiogram opens page 6: aortic stenosis, on record before the crash
    • The same page goes to the lienholder with the dispute

    Settlement attorneySees why a charge comes off before signing the letter that disputes it, and can answer the lienholder with the page itself.

  5. 05Strikes approved

    Strikes the agent proposes and the specialist decides, line by line

    How it works

    • Strike or keep each line, or approve all 14 proposed strikes at once
    • Keeping a line the agent reads as unrelated asks for a reason for the audit trail
    • Each struck line can be undone
    • 14 charges come off across four liens, $11,900 in all

    Lien resolution specialistKeeps the call on each charge with the person who answers for it, while the agent does the line-by-line reading.

  6. 06Reductions and the rules behind them

    Reduction rules worked as arithmetic, each with the plan term or statute cited

    How it works

    • One card per rule: the facts it needs, the arithmetic and whether it applies
    • Procurement cost takes $17,050 off Medicare at 36.47%, leaving $29,700
    • The fully insured health plan’s $31,600 falls to 0, since the client recovers 36% of her losses
    • Medicaid allocation checked and not needed; the hospital lien, filed on day 48, holds

    Settlement attorneyChecks each cut against its source before it goes in a letter, and knows a self-funded plan would follow its own terms.

  7. 07Medicare dispute letter

    Negotiation letters drafted with each figure linked to its source

    How it works

    • Five drafts: a Medicare dispute, a Medicaid request, a made-whole letter and two provider reductions
    • Its dispute to Medicare lists the 9 claims with date, diagnosis, amount and record page
    • It sets out the final demand the firm expects, $29,700
    • The specialist approves, the attorney signs, and agents send nothing

    Settlement attorneySigns letters that already cite the record and the arithmetic, so no draft needs rechecking figure by figure.

  8. 08Settlement waterfall

    A settlement waterfall where each lien bar shows what was claimed and cut

    How it works

    • Bars fall from the $425,000 gross through fee, costs and five liens to the client’s net
    • Each lien bar layers struck charges and the statutory cut over what is paid
    • A three-stop switch steps from as claimed to unrelated struck to reductions applied
    • The client’s net rises from $138,100 to $198,650

    Managing partnerSees in one picture how much of a settlement reaches the client, and where each lien dollar was won back.

  9. 09Signed settlement statement

    A settlement statement that opens disbursement only once the attorney signs

    How it works

    • Built from the negotiated liens: gross, fee, costs, each lien and the net
    • Liens total $71,350 against $131,900 claimed
    • Medicare’s $29,700 stays in trust until its final demand arrives
    • Disbursement stays locked until the lien total is signed

    Settlement coordinatorPays out of trust knowing each lienholder is on the sheet and the total is signed, with nobody signing and disbursing on the same case.

Five liens on a hip-fracture settlement, $131,900 claimed and $71,350 paid

The worked case: $425,000 gross, a 35% fee and $155,000 of fee and costs together.

LienholderClaimedTaken off, and whyNegotiated
Medicare48,2001,450 in 9 unrelated charges, then 17,050 for procurement cost29,700
Medicaid9,4002,150 in 2 unrelated charges7,250
Former employer’s health plan, fully insured31,60031,600 under the made-whole rule0
Hospital lien27,3005,900 in 2 unrelated consults21,400
Therapy on a letter of protection15,4002,400 in 1 unrelated charge13,000
All five liens131,90060,55071,350

Heart care, the wrong shoulder, a plan owed nothing and a lien that holds

Four calls from the same file, each backed by a page the lienholder can read.

Heart care from before the crash

A $418.90 echocardiogram on the Medicare list treats aortic stenosis diagnosed years earlier. It comes off, with chronology page 6 attached to the dispute.

Therapy on the wrong shoulder

The therapist billed 12 visits for the left shoulder, an older injury. The crash hurt the right side, so $2,400 comes off the balance.

A plan that recovers nothing

The plan document says the health plan is fully insured, so the made-whole rule applies. The client recovers 36% of her losses, and the $31,600 claim falls away.

A hospital lien that stands

Filed on day 48 after discharge, inside the 75-day window, the hospital’s lien is valid and gets paid, less $5,900 for two consults on older conditions.

Around the lien total

More of the lien file: the first waterfall, the overrides and the audit trail

What the specialist, the attorney and the firm administrator open around the signature.

The waterfall as claimedBefore any strike, the five liens take $131,900 and the client’s net stands at $138,100. The next step points to 14 proposed strikes.
Overruling the agentKeeping a charge the agent reads as unrelated raises the lien, so the specialist picks a reason before it saves to the audit trail.
The therapist’s balanceOne of five therapy lines is unrelated: 12 visits for the left shoulder, cited to the chronology page that records the earlier injury.
No reimbursement owedThe made-whole letter sets the plan’s claim against the valued losses and the recovery, each highlighted figure opening its source page.
One power per roleApproving strikes, signing the lien total, disbursing and changing rules each sit with one role, and a change to the roles is logged.
Each decision, in orderAgent steps and people’s decisions on one case, newest first, kept for six years after the final distribution.

Striking, signing and paying out sit with three different people

Agents do the reading, the matching, the arithmetic and the drafting. Four people make the calls.

Striking a chargeThe agent proposes. The lien specialist strikes or keeps each line, and keeping one takes a reason.
Signing the letters and the lien totalOnly the settlement attorney signs, after seeing the record page and the arithmetic behind each figure.
Paying out of trustThe settlement coordinator disburses once the total is signed, and cannot approve a strike or sign.
Releasing the Medicare holdMedicare’s share stays in trust until its final demand arrives. If the demand comes in lower, the difference goes to the client.
Contacting a lienholderAgents draft and cite; they never send. Each letter leaves the firm under a lawyer’s signature.
Changing the rulesThe firm administrator sets reduction rules, relatedness rules, alerts and retention, and makes no case decisions.

Lien resolution questions from the settlement desk

What is lien resolution?

Lien resolution is finding, checking and paying each party that paid for an injured client’s care before the settlement leaves trust. This solution finds the lienholders, audits each itemized list against the injuries, applies the reduction rules with their source cited, drafts the letters and builds the settlement statement for the attorney to sign.

How does it decide a charge is unrelated to the crash?

The charge auditor matches each line to the injuries in the medical chronology by date, diagnosis code and body part. Care for a condition diagnosed before the crash, routine screenings and vaccines read as unrelated, and anything unclear goes to the specialist. The agent proposes; the specialist strikes.

Can a Medicare lien be reduced after a settlement?

Yes. Conditional payments for unrelated care can be disputed before the final demand, and Medicare bears its share of the fees and costs of getting the settlement. The solution drafts the dispute with each record page and checks the final demand against that procurement-cost arithmetic.

What happens if the firm misses a Medicare final demand?

Interest runs once the payment window closes, and a dispute does not stop it. Medicare can recover from anyone who received the settlement, the lawyer included, and double damages are possible. The deadline tracker alerts the attorney ahead of each demand, and the Medicare amount stays in trust until it is paid.

Does it handle self-funded employer plans?

Yes, on their own terms. State made-whole and pro-rata rules reach only fully insured plans, so the reduction calculator reads the plan document first and keeps state rules off a self-funded plan. For a plan silent on fees, it applies the common fund rule.

How is the client’s health information protected?

It is read only inside the firm’s workspace, and each read is on the audit trail. Trust and lien records are kept for the firm’s retention period after the final distribution, then deleted with a log.

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A lien total your attorney signs
with each cut cited to its page.

Pick a closed case of yours: we’ll run its lienholder search and charge audit, then build the lien total for your attorney to sign.

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