Nursing home negligence cases often involve complex medical claims, leading to high lien amounts. Due to the many complicating factors and pre-existing conditions, an individual involved in a nursing home negligence case may experience a thorough review of these charges as it is a critical component of any nursing home negligence case.
In this case, Precision Resolution Case Manager Hanna Franco successfully reduced the total liens from $137,623 to just $4,666, saving the plaintiff a significant portion of the proceeds in a case where – like many nursing home cases – settlement amounts may be limited. Here’s how we did it.
The Case: Nursing Home Negligence and Severe Injuries
This case involved a nursing home negligence lawsuit where the plaintiff suffered from sacral pressure ulcer (Stage 4) injuries due to improper care. The case ultimately settled for $137,000, but the recovery contractor for the Medicare Advantage Plan initially identified $127,266 in claims, nearly consuming the entire settlement.
Identifying Unrelated Medical Claims
After conducting a thorough review of the medical records, Precision Resolution discovered that most of the claims appearing on the lien itemization were unrelated to the injuries caused by the nursing home’s negligence. We promptly submitted a dispute, arguing that these charges should be removed.
The Initial Lien Reduction
Our dispute was successful, leading to a removal of $114,568 in unrelated claims, bringing the lien amount down to just $12,698. Following the application of the plan’s procurement cost reduction, the final lien amount for the Medicare Advantage Plan was $4,666.
Medicare Lien Dispute: Reducing Another $10,357 to $0.00
In addition to the Medicare Advantage Plan lien, Medicare itself had identified $10,357 in claims. Upon reviewing these charges, we determined that none of them were related to the liability case. We submitted a full dispute for these claims, and Medicare agreed to remove all $10,357 – bringing their final lien to $0.00.
Total Savings Achieved
By aggressively disputing unrelated charges and negotiating reductions, Precision Resolution successfully lowered the total lien burden from $137,623 to just $4,666. This case highlights the importance of diligent lien review, strategic dispute submission, and persistent negotiation in achieving maximum financial recovery for plaintiffs in nursing home negligence cases.
Key Takeaways for Law Firms & Plaintiffs
This case offers valuable insights:
Always Request full itemized reports—A thorough review of the itemized lien report can uncover errors and excessive charges.
Seek Pro-Rata Reductions – When a Medicare Advantage Plan asserts a lien, as with standard Medicare, pursue a pro-rata reduction of the lien amount for attorney fees and expenses pursuant to 42 CFR 411.37.
Protecting Settlements Through Effective Lien Resolution
Nursing home negligence cases can result in substantial liens that threaten a plaintiff’s settlement. However, with careful review, strategic disputes, and strong negotiation, it is possible to eliminate unjustified claims and protect the plaintiff’s recovery. In this case, Precision Resolution achieved an incredible lien reduction, ensuring that our client kept most of their settlement rather than paying unnecessary medical costs.
If you or your firm are dealing with complex lien resolution cases, contact us today to see how we can help you maximize settlement recovery and minimize lien obligations.
Precision Resolution offers premier outsourced lien resolution services for attorneys aiming to enhance client services, achieve optimal case outcomes, and maximize settlements for plaintiffs.
About Hanna
Hanna Franco is a dedicated and experienced case manager who brings a wealth of knowledge and a passion for client advocacy to our team. Her approach to case management is both compassionate and methodical, ensuring that each client receives personalized attention and support throughout their legal journey. To contact Hanna, email her at franco@precisionlienresolution.com.