Disclaimer: This article is for general information only and is not legal advice. I am not a lawyer. If you need legal advice about medical liens, insurance subrogation, or settlement strategy, contact a licensed Arkansas attorney.

Detailed answer — what “treatment on a lien” means and how it works in Arkansas

Treatment on a lien (sometimes called a medical lien, treatment by assignment, or Provider Lien Agreement) means a health-care provider agrees to treat you now and waits to be paid from the money you receive from a personal-injury settlement, judgment, or insurance recovery. The provider usually documents this arrangement in a written assignment or lien agreement. The provider does not guarantee payment; rather, the provider agrees to look to any recovery you obtain as the primary source of payment.

Arkansas does not prevent parties from using written assignment or lien agreements, and hospitals and medical providers commonly use such agreements in personal-injury matters. State law and local practice affect how liens are enforced and the order of priority among creditors. For general Arkansas statutes and codes that govern liens, the Arkansas Code and Title provisions addressing liens and hospital matters are authoritative; see the Arkansas Code hosted by the Arkansas Legislature: https://www.arkleg.state.ar.us/ (use the Arkansas Code search to find specific lien or hospital provisions).

How medical liens typically happen in Arkansas

• A provider (doctor, hospital, imaging center, or physical-therapy clinic) asks you to sign a written assignment or lien agreement that says the provider may be paid from any future recovery related to your injury.
• The provider treats you and bills the usual charges. The provider preserves a right to be paid from any settlement or judgment, and may file a lien notice if permitted by practice or statute.
• If you obtain a settlement, the provider asserts its claim against settlement proceeds. A lawyer for the claimant, defense, or the provider may negotiate how much of the settlement goes to pay medical bills.

Providers who commonly accept liens

• Hospital emergency departments and trauma centers (some hospitals will treat and later place a lien or work a settlement agreement).
• Orthopedic surgeons, neurosurgeons, pain management physicians, and rehabilitation clinics that regularly handle accident cases.
• Urgent care clinics, imaging centers, and physical-therapy clinics that have a history of working with attorneys on PI cases.

What you should expect in a written lien or assignment agreement

• Clear description of the services covered and the period of treatment.
• Language that assigns all or a portion of the provider’s right to payment from any recovery related to the injury.
• Any agreed percentage or fee-schedule for resolution of bills from settlement proceeds (some agreements set a negotiated discount in exchange for waiting for payment).
• Signatures and contact information for the provider and patient.
• A statement that the provider may file a lien or take collection steps if the matter does not resolve.

How to find providers in Arkansas who will treat on a lien

1. Contact personal-injury attorneys for referrals. Many PI attorneys in Arkansas maintain lists of local providers who accept lien-based treatment because it allows injured clients to get care immediately. Even if you do not want an attorney, an initial consultation can get you referrals and explain how a lien will affect settlement.
2. Ask hospital financial services or trauma center case managers. Hospitals often have case managers or a patient financial services office that can explain whether they will treat and later pursue payment from a recovery. Some hospitals have formal policies or charitable assistance programs for uninsured accident victims. Contact the hospital’s billing or patient financial services office and ask about “liens,” “assignment for payment from personal-injury settlements,” or “charity/discount policy.”
3. Call community clinics and specialized “personal injury” clinics. Some clinics advertise that they work with accident cases and accept assignment agreements. Search online for “personal injury clinic Arkansas,” “lien providers Arkansas,” or “medical lien Arkansas,” then confirm terms in writing.
4. Talk to your insurer and to Medicaid/Medicare if applicable. If you have private insurance, Medicaid (Arkansas Medicaid), or Medicare, those payers may have priority or subrogation rights. Arkansas Medicaid’s Division of County Operations and the Arkansas Department of Human Services explain recovery/subrogation obligations and how Medicaid may seek reimbursement from settlements: https://humanservices.arkansas.gov/divisions-medical-services/. Be careful: accepting a lien does not eliminate Medicaid or Medicare repayment obligations.
5. Ask attorneys for a “letter of protection” (LOP) or similar document. Many Arkansas attorneys will provide a written letter of protection that asks medical providers to hold their bills and look to settlement proceeds for payment. The exact form and practical effect vary; a written LOP or assignment clarifies each party’s expectations.
6. Check provider credentials and billing history. Verify that the provider is licensed and that the facility can document charges and treatment records you will need for your claim. For licensing status, consult state licensing boards and the Arkansas Department of Health: https://www.healthy.arkansas.gov/.

Practical steps to take when you find a willing provider

1. Insist on a written agreement that states the provider’s lien/assignment terms.
2. Make sure the provider documents medical necessity (records, imaging, referrals) — this strengthens both medical care and your claim.
3. Keep careful copies of all medical bills, records, and lien/assignment paperwork.
4. Tell any attorney you hire about all assignment/lien agreements so your attorney can negotiate bills and satisfy liens from settlement funds.
5. Understand that a lien does not guarantee full payment. Providers typically negotiate with claimants or attorneys about amounts payable from settlement proceeds.

Common complications specific to Arkansas to watch for

• State and federal health benefits (Medicaid, Medicare, ERISA plans) often require repayment from recoveries and may have priority over private provider liens. Check Arkansas Medicaid rules: https://humanservices.arkansas.gov/divisions-medical-services/.
• Hospitals sometimes have stronger collection remedies (including filing notices or liens) compared with small clinics. Know who you are signing with and whether the facility has a history of filing liens in court.
• If you settle your case without properly accounting for liens and subrogation, you may still owe those providers. Get legal help before signing release forms or accepting net settlement funds.

When to consult an Arkansas attorney

Talk to a personal-injury attorney before you sign any release or accept settlement money. An attorney can:

• Explain how liens, Medicaid/Medicare subrogation, and insurance offsets will affect your recovery;
• Negotiate reductions of medical bills and lien amounts;
• Draft or review letters of protection and assignment agreements; and
• Ensure lien holders are paid correctly from settlement proceeds so you do not face unexpected debt.

Helpful Hints

• Get the lien/assignment in writing before treatment starts. Oral promises create confusion.
• Keep detailed medical records and billing statements. These prove treatment and amounts owed.
• Ask whether the provider will accept a negotiated discount in exchange for waiting until settlement.
• If you have Medicaid or Medicare, notify your case manager and learn the repayment rules—these payers often must be reimbursed from settlements.
• Request itemized bills and copies of medical records early. These documents speed settlement negotiations.
• If a provider says they will not accept a lien, ask about payment plans or hospital charity programs.
• Before settling, get a written accounting of all liens and subrogation claims so you know your likely net recovery.