(a) For the purposes of this section, the following terms shall have the following meanings:
(1) HEALTH CARE PAYOR. A health care insurer, health maintenance organization, or health care service plan organized under Article 6, Chapter 20, Title 10A, authorized to provide health care coverage in the state.
(2) SATISFY THE CLAIM. Receipt by the hospital of either of the following:
a. Full payment for services as billed.
b. If the hospital has a contract with the injured person's health care payor, payment together with all credits, discounts, and contractual adjustments that the patient's bill would be entitled under the contract, including recoupments, between the hospital and the patient's health care payor which extinguish the patient's obligation for the services rendered.
(b) Unless specifically contrary to any contractual agreement between the hospital and the injured person's health care payor or unless contrary to any statute or governmental rule or regulation of the United States or this state, no hospital shall perfect a lien as to any injured person who was covered by a health care payor's policy, until the hospital submits to the health care payor an accurate and properly coded claim, or if a contract exists between the hospital and the health care payor, in the form required pursuant to the contract, and there is a failure to satisfy the claim. Perfection of a lien shall be as follows:
(1) A hospital may perfect its lien as to an injured person who was covered by a health care payor's policy that provides primary coverage for the care, if the hospital takes the steps described in subsection (c), within 20 days after its receipt of notice of the health care payor's denial of an accurate and properly coded claim. Failure to satisfy an accurate and properly coded claim within 45 days of submission or the subsequent recoupment by the health care payor of amounts previously paid, which results in a failure to satisfy the claim, shall be deemed a denial of the claim.
(2) A hospital may perfect its lien as to an injured person who was not known to the hospital to be covered by a health care payor, was covered by a governmental payor including Medicare or Medicaid, or was covered by a policy not described in subdivision (b)(1), if it takes the steps described in subsection (c) within 20 days after discharge.
(3) Where the hospital does not receive evidence of the injured person's health care payor until after the lien provided for by this section has been perfected, the hospital shall bill the health care payor forthwith but may retain its lien until satisfaction of the claim. If the claim is satisfied, the hospital shall release the lien within 10 days.
(c) In order to perfect a lien under this division, the operator of the hospital, shall file with the probate court of the county in which the hospital is located a verified statement setting forth the name and address of the patient, as it shall appear on the records of the hospital, the name and location of the hospital and the name and address of the operator thereof, the dates of admission and discharge of the patient therefrom, the amount claimed to be due for the hospital care, which shall give full credit for any health care payor payments made, including agreed contractual adjustments, and to the best of the claimant's knowledge, the names and addresses of all persons, firms, or corporations claimed by the injured person, or the legal representative of the person, to be liable for damages arising from the injuries. The claimant shall also within one day after the filing of the claim or lien, mail a copy thereof by registered or certified mail, postage prepaid, for each person, firm, or corporation so claimed to be liable on account of the injuries, at the addresses so given in the statement, and to the patient, his or her guardian, or his or her personal representative at the address given at the time of admission.
(d) The filing of a claim or lien shall be notice thereof to all persons, firms, or corporations liable for damages, whether or not they are named in the claim or lien. Nothing shall be deemed to preclude the hospital from perfecting its lien outside of the time limits stated in this section through providing actual notice to persons, firms, or corporations.
(e) The judge of probate shall endorse thereon the date and hour of filing, and at the expense of the county shall provide a hospital lien book with proper index in which he or she shall enter the date and hour of the filing, the names and addresses of the hospital, the operators thereof and of the patient, the amount claimed and the names and addresses of those claimed to be liable for damages. The information shall be recorded in the name of the patient. The judge of probate shall be paid one dollar ($1) as his or her fee for the filing.
Last modified: May 3, 2021