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Strategies For Staying On Top of Your Lien

Saturday, October 26, 2002 | 1316 | 0 | min read

In California, many physicians provide treatment to injured workers at the request of the attorney on a lien basis. Typically this occurs where an injured worker's claim has been denied by the insurance company as not arising out of, or in connection with, employment. The way in which the physician protects his billing is with a lien. This is not a discussion on the technical aspects of qualifying a lien, or enforcement rights. Rather, we will explore some common sense strategies to staying on top of outstanding liens, and making sure that every effort is put forth in the collection of liens.

Filing the LienFirst off, and perhaps a bit fundamental, but nevertheless important, you have to ensure that your lien is properly filed and served. A lien for medical treatment on an injury denied case may be filed and served along with the billing. A lien for medical-legal work, however, cannot be filed unless your billing remains unpaid for sixty days after receipt by the carrier or your receipt in writing of an objection within 30 days after the billing has been received by the carrier (Regulation section 10771).

The lien must first be filed with the Board. The Board receives many thousands of lien forms every day. With current staffing shortages, it is a wonder that more paper liens are not lost or misfiled. The very best way to ensure that your lien is filed with the Board is through the WCAB's EDEX system.

EDEX was started as California's medical lien management system for the Board (though it has essentially defaulted to the state's case management system for various reasons). The system allows you to electronically file, via various communications protocol, your lien directly with the Board. Your lien is automatically sorted and placed in the correct Board file, and you are automatically added to the Official Mailing List so that you do not miss important hearing notices or the service of other important documents, such as defense reports, by the opposition.

There is a fee to have your lien electronically filed, but the fee is de minimis after you have had the misfortune of not getting paid a couple of times because your lien was not reflected in the Board file.

Filing your lien through EDEX also means you automatically receive hearing notices and other important case event notices. If you are not at a hearing to enforce your lien rights, then you are not going to get paid.

One other thing about your lien - it must be served. Failure to serve on a party defendant may not completely negate your lien, but it will delay recovery on that lien.

Service is a legal process whereby the person delivering the legal document attests that the document was delivered in accordance with legally proscribed means. Most of the time service of a lien can be accomplished via first class mail, with a proof of service (writing whereby the person serving declares under penalty of perjury that the document was delivered in the manner described). If you use EDEX you can be certain that you will have all of the addresses that are on the Official Mailing List - this is sufficient for service purposes. Some EDEX services (such as workcompcentral) provide you an easy pre-formatted lien after electronic filing so you can simply fold and stuff window envelopes, or will take care of that task for you for a small fee.

Consider assigning your lien to a hearing representative firm. There are many in this field that specialize in representing medical providers at WCAB hearings. They have special training and skills in enforcing lien rights at workers' compensation hearings, and know the applicable Labor Code, Regulations and Case Law. In addition, most have developed relationships over the years with the attorneys and judges that populate local WCAB venues - a resource that cannot be duplicated by the practitioner in the office. If you have a great volume and want more control over your cases, consider hiring a full time hearing representative as a part of your staff's billing department. Be sure that your hearing representative is provided not only with your bills and liens, but all medical evidence you have in your possession, including any medical reports in your file, not just your own. The file should be transmitted to the hearing representative several days before any assigned hearing so that they have time to read the file and properly prepare the case for hearing.

Lien based medical services is not for every provider, but should be a part of any injured workers practice. Collections can take 6 months or more after services have terminated, so alternative sources of cash flow are important. But you stand an opportunity to provide important services to injured workers who otherwise cannot get the medical service they need, and, as will be explored in future articles, you stand the chance to increase your bill through various penalty issues and techniques.


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