Lien Knowledge for Timely Resolution

Claims Management
Cost Containment

July 09, 2019

After providing medical treatment to injured workers, providers can file a lien against the work comp claim to the Workers’ Compensation Appeals Board (WCAB) to pursue settlement of their billing. However, liens often get hung up in trial and result in a lengthy, costly legal process. Because of this, it is crucial to have an experienced partner assist in timely and efficient lien resolution.

Recently, a notoriously litigious lien claimant brought CorVel and our co-defendant to trial on the basis of whether a claimant’s treatment constituted a medical-legal (ML) charge. At trial, the judge advised the lien claimant that there would be an adverse ruling for them if they continued to pursue the issue in an effort to avoid wasting time. Despite the judge’s warning, the lien claimant agreed to move forward with the trial, resulting in a Findings & Order against the lien claimant. The lien claimant then filed a Petition for Reconsideration resulting in a second round of litigation on the issue.

To quickly resolve the case and avoid a lengthy trial, a CorVel in-house lien specialist conducted further research into what constitutes a ML charge and determined the lien did not qualify. Charlie Camareno, CorVel’s Provider Network Manager, explains, “In order for charges to be considered Med-Legal, they have to be requested by the parties (namely the applicant and their attorney, or the Defense Attorney) and specifically for the purpose of proving or disproving a contested portion of the claim. In this case, the provider was charging for a consultation and testing that was requested by the Primary Treating Physician, who does not qualify as a party according to the regulations. Additionally, the denial of claim hadn’t been issued at the time these services were requested or rendered, so technically, there was no dispute to contest by way of Med-Legal examination or reporting.”

After sharing their findings with the trial judge, our lien specialist filed a Petition for Costs and Sanctions and reached a timely settlement with the lien claimant’s attorney. In result, the lien claimant agreed to cover the costs incurred by CorVel and our co-defendant over the course of litigation.

CorVel’s lien specialists have an established rapport in the industry and avoid unnecessary costs and delays by using established timelines to ensure timely lien analysis, negotiations, and resolution.

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