Unsure how to calculate chiropractic liens or respond to attorney reduction requests? The ICS Lien Calculator simplifies Illinois lien calculations and helps you determine what you’re entitled to collect.
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Transcript:
We get regular questions from members about liens and exactly how they’re calculated because it can get actually a little complex because of the percentages that are involved and the potential 33% or 1/3, and and also the potential for up to 40% depending on certain circumstances, and then of course, many of you get these requests from attorneys to reduce your amounts, and you’re not really certain if that reduction is appropriate under the law. So we wanted to give you an ability to be able to calculate and make the determination based on how the law is written and the exact structure for the calculation. So we do have an online calculator that is available to members that breaks all of this down.
Now, the way you get that is when you go to the ICS, go under Member Benefits, and you just select Lien Calculator. It will take you to this specific page. It’ll walk you through some general information about the Lien Calculator and how to use it, but I’m going to walk you through that today. And so you scroll down to the form, and you’ll go ahead and just key in your information. I’m just going to put in Illinois Chiropractic Society. If there is a lien involved, then you want to make sure that you include what that is. So when you find out the lien amount from the attorney, and this is something that you have the right to be able to find out. So if they’re just telling you, “I’m willing to give you this much money, you can actually return that email and say, “Hey, or that letter, or give them a call and say, “We need to know exactly how much the settlement is. Right.
So in this case, your lien amount. Let’s say you’ve done $1,000 worth of services for your patients, or for your patient in this particular case, and the total settlement amount, and I’m going to make things up as we go, is $7,000. So now this one is going to be pretty easy because if you’re the only person that’s involved, then you’re going to get your full settlement amount. By the way, these results calculate instantly as you begin to enter more information, so you’ll see that collectible under this settlement for the lien is going to be $1,000. So let’s say now you have another professional or another provider that’s involved in this. Let’s say you have another medical doctor. Now, understand, you’ll see here professionals are physicians, dentists, optometrists, natropaths, clinical psychologists, or physical therapists. These are all specifically included by statute and named by name. So let’s just say you have a dentist that’s involved. You go ahead and key in; you can put in the dentist’s name for your records. We don’t keep any of this. This is not coming to the ICS. This is really just producing data for you instantly, so we don’t track that information.
Now, in this case, because you’re just going to name who it is according to the information that you have received from the attorney, and you can actually request this. Much like the settlement amount, you can request who are the other lien holders on this case, and they’re required to give it to you; then you choose: Are they a professional or a provider? Well, the dentist is specifically listed as a professional, so you’ll select them. This matters because when we start talking about 1/3 or up to 40%, that’s where that threshold comes into play. The only time you can go over 1/3 is when there are both professionals and providers included as lien holders for a particular settlement. So in this case, again, we’re just going to make up some numbers. The dental work was $3,000, and you can see as that dentist amount went up, as their lien amount went up, your potential allowance under the lien, or what is payable by the lien, and we’re only talking about the lien because don’t forget you can actually collect up to your full amount as long as you have that agreement with the patient up front, right? And you haven’t satisfied or settled anything, right? So you haven’t settled your full bill, then you’re entitled to balance bill that patient up to the full lien amount. The lien statute specifically gives you that authority.
Now, so in this case, $583, and then the remaining, and it very clearly indicates that you can balance bill that amount, is the 416 67. So now, let’s say in this case, and we’re just going to make this up. Let’s say in this particular case that the attorney comes back and says, “You’re the only two lien holders, and we’re willing to give you $300. Of course, you’re allowed under the lien to get up to $583.33. So what we have done is make it super simple. Let’s say you get an email from the attorney; you can actually just copy this response. If you click Copy Response, it’ll actually put it inside your clipboard on your computer, and you can paste it into the email. And what you’re telling the attorney in this particular case is, look, we’re entitled to $583.33 to satisfy our lien, specifically just to satisfy the lien. Assuming the settlement amount that you provide is final, we’re willing to accept $583.33 to satisfy our lien. However, our acceptance of this amount does not act as a general release, and we reserve the right to balance bill the patient for the remaining.
Now, I’m not reading it to you just to read it to you and insult your intelligence, but I’m reading it to you because it’s important to understand the differences: one, you’re accepting the $583.33 for your lien, but you’re also reserving the right to balance bill the patient for the remaining amount. Now, remember, whatever the other portion is- so, in this case, the the remaining the remaining portions that aren’t covered by the lien are going to typically go to cover the attorney’s expenses, and then the remaining is typically divided 50/50 with the attorney and the patient. So the patient is going to have funds coming to them from this settlement. So they do have some funds coming ultimately that you would be able to balance bill from them for that remaining amount. So now, once you’re done, and by the way, you can add additional lien holders.
This will say the dentist wasn’t the only one, and now you have a hospital involved, and the hospital was, in this case, is going to be, or is always a provider. You can see that list above as well, and the hospital’s bill was $3,000. Now, notice your settlement amounts also going to go down again, but now we’re tapping into potentially more, so it didn’t go down on an equal basis as to what it did before, and that’s because we’re now getting into that 40% realm because you can bump up to the 40% and it’s a complicated calculation, which is why we do have the calculator. But what this means is, again, this copied response does calculate automatically. You can see now the new amount is 350, and the reserved amount to make sure that you can bounce below the patient is now at the 650 amount.
But the other side of this is you may want something for your records, so you have something to refer back to in the future. And so we wanted to give you the ability to be able to click and print a detailed report. And so, very quickly, you can get a detailed report. It’ll have all of the information you just entered, including the suggested attorney response. In this case, then you just print this to your printer, and you can put it in the file, or you can print it to PDF and put it in your EHR system, so you have access to be able to see exactly why you responded the way you did to the attorney, and have all of that information.
Now, this is available to ICS members again. Member benefits, lien calculator, and you can key in, and you can add as many lien holders as you need under a certain case. Just add in all the exact amounts that you should be getting from the attorney, and you can push back and tell the attorney that you’re entitled to receive these under the Illinois Healthcare Lien Act. And in this case, we believe that this is going to help you receive the funds that you’re entitled to. You provide a good and valuable service, and you deserve to be paid for it. And we’ll catch you next week.
