Working on liens and letters of protection; do you do it, what are the pros and cons?

[Ligament]

I'm considering doing some lien work/letter of protection work on MVA and personal injury cases. I have little experience with this. Do you have any experience to share? How much do you bill? Appreciate your thoughts.

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[drusso]

I'm considering doing some lien work/letter of protection work on MVA and personal injury cases. I have little experience with this. Do you have any experience to share? How much do you bill? Appreciate your thoughts.

You can basically bill charges. But, you're betting on the come. It can take years and years for these cases to grind through the system and the doctors are ALWAYS paid last. Also, expect that whatever your bill is it will be negotiated down because the settlement wasn't as big as expected, the legal fees were higher than expected, and, oh yeah, doctors get paid last...

 

[swamprat]

You can basically bill charges. But, you're betting on the come. It can take years and years for these cases to grind through the system and the doctors are ALWAYS paid last. Also, expect that whatever your bill is it will be negotiated down because the settlement wasn't as big as expected, the legal fees were higher than expected, and, oh yeah, doctors get paid last...

it does pay pretty well though . They can’t fully **** you as you can reject their reduction which leads to the coiffed deciding . More time and money. Need to have decent relationship with law firm I think

 

[Ligament]

it does pay pretty well though . They can’t fully **** you as you can reject their reduction which leads to the coiffed deciding . More time and money. Need to have decent relationship with law firm I think

What % of medicare charges do you bill these cases for?

 

[Ligament]

I know some of you do a lot of this type of work, you would not be doing it if not profitable. What are the best practices of the trade?

 

[Aether2000]

I found some WC lawyers want to drive the medical procedures to jack up charges, in order to impress the judges with the severity of the condition. We have a surgeon in our area that will perform on WC patients a ACDF for mild disc bulges without myelopathy or radiculopathy or radicular pain. During the same procedure he does 3 level bilateral RF cervical with the needle nowhere near the medial branch, then injects stem cells into the discs. He doesn't collect immediately, but does eventually collect and is doing quite well financially.

 

[gdub25]

Agree with Drusso, takes a long time to get paid and often fees are negotiated down. You have to file lien on every single one of them so that they can’t just runoff without paying you. Last I saw the avg charge for an ESI on MVA was around $4,000 in my area. I recently talked with an attorney in Dallas who says avg there is $7,000. Even if fees are reduced by 50% it’s still a lot of money for an injection. We don’t really participate in this business, previous partner did.

 

[Laryngospasm]

Lots of renegotiations and asking you to change your note this way or that. It gets pretty frustrating and feels slimy. All the attorneys are dbags. It’s not fun. And if you won’t play their game they WILL find someone who will.

 

[promethius]

I used to do a fair amount of personal injury when I was working for another group. Having started my own practice, I have been treating patients with traditional insurance.

A patient recently called wanting to be seen through personal injury. The patient's lawyer told my practice to draft a letter of protection and have the patient sign it before submitting it to their law firm for approval. I thought the law firm was supposed to present the medical practice with the letter of protection for approval, not the other way around? What terms should go into drafting a letter of protection? How is a letter of protection different from a lien? Should the charges for treatment (as a percentage of Medicare rates) be specified in the letter of protection prior to agreeing to see the patient?

 

[soccrwz]

They write the LOP usually and send it to you, its pretty boilerplate