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Liens, Subrogation, and Dates of Incident

The date of incident might be the second most important piece of data in subrogation and liens.  Only the actual injuries involved are more important to your lien resolution than date of incident.  Surprisingly, many attorneys simply do not realize the effect an incorrect date of incident can have on their cases.

Consequences

An incorrect date of incident can lead to enormous fluctuations in lien amounts.  In an era where one surgery can be billed for $100,000.00, an extra day here or there can cost you and your client incredible sums of money.  This incorrectly increased lien could harm the ability to settle, leading plaintiffs and defendants alike to spend more money in litigation. 

But what if the date of incident had been correctly listed for just a few days later?  Perhaps the lien would have been cut in half.  And a settlement might become more likely.

Even if you discover that your lien holder, such as the MSPRC for Medicare, or a state Medicaid lien, has an incorrect date of incident, you will still waste valuable time.  In order to change a date of incident, Medicare’s MSPRC must first close its entire file.  Then, the plaintiff’s attorney or third-party lien resolution agency must re-report to the Coordination of Benefits Contractor (COBC).  This slows lien resolution by at least 100 days (see Medicare blog post on timelines).

How do Healthcare Lien Holders Determine a Date of Incident?

Healthcare lien holders have different ways to determine a date of incident.  All of them allow you to specify the date; however, many private insurance lien holders have certain codes that alert them to possible negligence.  As a result, they often can determine a date of incident on their own. 

Generally, all insurers, especially Medicare and state Medicaid services, require you to notify them of a personal injury case.  This means that you can specify the date of incident.  Most important to this procedure is that both the MSPRC/Medicare and state Medicaid agencies will take your date of incident as being correct.  For the most part, these entities will not ask questions unless the representative notices a discrepancy (this occurs most often when the plaintiff/beneficiary had not been hospitalized prior to the negligence).

Get it Right

But more often than not, they take your word for it.  Getting the date right can save you money and time.  Even when you use a lien resolution service, you need to be careful to specify the date of incident to that service.  Depending on your jurisdiction, the notice of intent, complaint, and facilitation summaries are all great resources to pinpoint your date of incident.  Get it right!

Ryan Weiner
Co-Founder Lien Resolution Services
www.lienresolutionusa.com
https://lienblog.wordpress.com
rweiner@lienresolutionusa.com
This Blog/Web Site is made available by the publisher for educational purposes only as well as to give you general information and a general understanding of the law, not to provide specific legal advice. By using this blog site you understand that there is no attorney client relationship between you and the Blog/Web Site publisher. The Blog/Web Site should not be used as a substitute for competent legal advice from a licensed professional attorney in your state.
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About Ryan J. Weiner

Co-Founder of Lien Resolution Services, LLC, a national healthcare lien resolution firm. Our goal is to assist in the fair administration and resolution of healthcare liens on personal injury cases. Please visit our website for more information: www.lienresolutionusa.com.

One comment on “Liens, Subrogation, and Dates of Incident

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