This article has been published in "The Advocate", a monthly publication of the Arizona Association for Justice/Arizona Trial Lawyers Association, May 2007 issue, @2007 by Steven J. Bruzonsky, Esq.
A.R.S. § 33-931 ET SEQ LIENS FILED BY HEALTH CARE PROVIDERS OTHER THAN HOSPITALS OR AMBULANCES
Following is a letter that I recently wrote to a local Radiologist that filed the lien more than thirty days after providing the services, and therefore the lien is ineffective against my client's personal injury settlement. The attached Memo briefly summarizes Arizona statutory lien law as well. As discussed below, beware, there are different filing time limits for hospitals and ambulance services (within thirty days of settlement) vs other health care providers (within thirty days of providing any accident-related service).
March 30, 2007
Legal/Auto Lien Department _________ Radiology
Re: Our Client/Your Patient:
Date of Accident: 11-27-06
A.R.S. 33-931 et seq Lien in amount of $318.00+ filed on 2-22-07
Date(s) of Medical Care by Your Facility/Office: 12-7-06 AND 1-8-07
Patient's Health Insurance: Aetna
We understand that you have filed with the local County Recorder's office the above statutory lien, attempting to balance bill the amount of the billed charges, less payment by the patient's health insurance, from the patient's upcoming personal injury settlement.
However, your lien is not effective against our client's personal injury settlement for the following reasons:
1. As you are not a hospital or ambulance service, you have failed to file/perfect the lien within thirty days after the patient has received any accident-related services from you. A.R.S. 33-932(A) and 33-932(C).
2. Even if the lien were effective, it would only be applicable to your customary charges in excess of $250.00.
Please be advised that our firm will not be honoring your invalid lien claim. Please file a Lien Release immediately or you will be subject to legal action. If a Lien Release is not filed, with a copy to our office, within thirty days, then we have advised our client to file a complaint with their health insurance carrier regarding your violating your contact with the carrier and your violating A.R.S. 20-1072.
Please see Memo below for more information.
Thank you for your courtesy and assistance.
Very truly yours,
Steven J. Bruzonsky
MEMO RE REQUIREMENTS FOR STATUTORY LIENS A.R.S. 33-931ET SEQ
A.R.S. 20-1072 provides that you as a participating provider with the patient's health insurance, you are required to bill the patient's health insurance, and you may only charge the patient the copay or deductible allowed under the policy. Please advise of the copay or deductible amount due.
The only exception to the above is if you file a timely A.R.S. 33-931 et seq statutory lien.
A.R.S. 33-931(A) states that the lien applies to "all claims of liability or indemnity, except health insurance and underinsured and uninsured motorist coverage - - -."
A.R.S. 33-931(C) states that the lien is "applicable to all customary charges by hospitals or ambulances of political subdivisions, but are restricted to customary charges in excess of two hundred fifty dollars by all other providers and privately owned ambulance companies excluding interest and service charges."
A.R.S. 33-932(A) provides that a hospital may "perfect" the lien by recording it "within thirty days after the patient is discharged". A.R.S. 33-932(D) provides that the hospital lien, as well as any ambulance service lien, is effective if recorded thirty days before settlement, except that if lien is accessible on the internet, then the lien info must be accessible on the internet thirty days before settlement.
A.R.S. 33-932(A) provides that health care providers (except hospitals) are required to record the lien "before or within thirty days after the patient has received any services relating to the injuries". A.R.S. 33-932(C) provides that "If a health care provider other than a hospital or ambulance service does not record the - - - lien - - - as provided in this section, the - - - lien - - - is invalid and may not be enforced by the cause of action provided in section 33-934. " The A.R.S. 33-932(D) exception that hospital and ambulance liens are "effective" if recorded thirty days prior to settlement doesn't include other health care providers.
A.R.S. 33-936 provides that a lienholder or assignee that fails to grant a release within thirty days after satisfaction of the lienholder or assignee is subject to liability in the amount of one hundred dollars and also to liability for actual damages.