Lien Basics
This document allows a healthcare provider to delay payment in a personal injury case, with a promise to be paid from the settlement.
What is a Letter of Protection (LOP)?
A patient has lingering symptoms after a concussion, such as headaches, dizziness, and sensitivity to light.
Who is a Neurologist?
These are made to a bill when insurance companies and providers agree to a lower rate.
What are Adjustments?
This term describes how an injury happened and how it was caused.
What is Mechanism of Injury?
This is inflammation of a tendon often due to overuse.
What is Tendonitis? ✅ Soft tissue
This tear in the shoulder's stabilizing muscles may lead to surgery, especially in athletes.
What is a Rotator Cuff Tear? ✅ Surgery likely
When a patient misses several medical appointments without explanation.
What are Gaps in Treatment?
Medicare, Medicaid, and the VA are examples of this type of lienholder.
Who are government lienholders?
A client reports neck pain after a rear-end collision. The provider uses manual therapy and exercise.
Who is a Chiropractor or Physical Therapist?
This type of mistake occurs when the same charge appears more than once on a bill.
What are Duplicates?
These four letters stand for a format used in PT and chiropractic records that includes Subjective, Objective, Assessment, and Plan.
What is SOAP?
This superficial scrape usually occurs after a fall.
What is an Abrasion? ✅ Soft tissue
This spinal condition involves a disc pushing into nerves and sometimes requires surgery.
What is a Bulging Disc? ✅ Surgery possible
This issue occurs when different parts of the record tell conflicting stories about how the accident happened.
What are Inconsistencies?
Even if a case is lost or settles low, this person is still responsible for medical bills under an LOP.
Who is the client?
A person suffers flashbacks and anxiety after a traumatic event. They are referred for mental health therapy.
Who is a Psychologist or Psychiatrist?
These amounts may be removed due to billing errors or charity programs.
What are Write-offs?
This type of note gives a summary of the entire ER visit, including treatment, diagnosis, and follow-up care instructions.
What is a Discharge Summary?
A break in a bone caused by trauma.
What is a Fracture? ❌ Not soft tissue
This injury involves a bruise from blunt trauma and usually heals without surgery.
What is a Contusion? ❌ Surgery not likely
This occurs when a provider bills for services that don’t match the injury or accident details, and may be caught by reviewing CPT codes
What is Improper or Unrelated Billing?
This military health insurance program may assert a lien for reimbursement if it paid for injury-related treatment.
What is Tricare?
A client has radiating lower back pain due to a ruptured spinal disc and may need injections or surgery.
Who is an Orthopedic Surgeon or Pain Management Specialist?
The line item on a bill that describes the amount for that DOS.
What is Amount Paid?
Visible evidence or only what the patient’s report.
What is Subjective
A deep cut in the skin, often caused by sharp objects.
What is a Laceration? ✅ Soft tissue
This knee injury affects the ACL or MCL and often results in surgical repair.
What is an ACL/MCL Tear? ✅ Surgery likely
This red flag appears when records show the client arrived at the ER under the influence.
What is Drug or Alcohol Use?
If this type of insurance paid for treatment, a final ledger must be requested to determine what was paid and what is still owed.
What is Workers’ Compensation (WC)?
| A client suffers from chronic back pain and is referred for epidural steroid injections to manage inflammation.
Who is a Pain Management Specialist? |
The number located on a bill or record that explains the type of appointment that the client had that day.
What is CPT Code?
This word refers to whether a charge or treatment is directly linked to the accident in question.
What is Relatedness?
An injury from extreme force that damages both skin and muscle beneath.
What is a Crush Injury? ❌ Not purely soft tissue (includes bone/muscle damage)
This is internal bleeding from trauma, often hidden and potentially life-threatening.
What is Internal Bleeding? ✅ Emergency surgery likely
These medical services should be removed from liens if they are for unrelated issues like a flu shot or yearly physical.
What is True (Unrelated Charges)