This form is a Medical Lien Agreement. The clien authorizes a health care provider to furnish his/her attorney with prepaid copies of certain medical records relevant to the client's injury or accident. The client also acknowledges that he/she is directly responsible to the health care provider for all medical bills submitted by them for services rendered.
Attorney Lien Form For Medical Treatment
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How to fill out Patient - Attorney Medical Lien Agreement?
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FAQ
The definition of a medical lien To answer the question of what is a medical lien is fairly simple: It's a legally binding agreement between a healthcare provider and the patient. It gives the healthcare provider the ability to recoup money owed for treatment by placing a request on the patient's personal injury claim.
The lien allows the medical provider to be paid from the proceeds of settlement before you receive any money. For hospitals, Indiana has set up a special statute entitled the Indiana Hospital Lien Statute that dictates when and how hospitals can place a medical lien on proceeds and how the liens are to be paid.
What is a Medical Lien or Hospital Lien? Medical and hospital liens are legally binding contracts between patients and their healthcare provider, such as the hospital or doctor. The lien agreement stipulates that the provider must offer medical treatment to the patient.
(a) A person, a firm, a partnership, an association, a limited liability company, or a corporation maintaining a hospital in Indiana or a hospital owned, maintained, or operated by the state or a political subdivision has a lien for all reasonable and necessary Page 2 charges for hospital care, treatment, and ...
The lien does not attach to any real or personal property of the injured party. The lien does not attach to any workers' compensation benefits. The hospital has no independent right to assert a cause of action against any potential responsible party.