Can I get medical treatment on a lien for a personal injury in Colorado?

Short answer: Yes — many Colorado providers and facilities will treat injury patients on a lien or by using a letter of protection (LOP), but acceptance varies by provider, medical specialty, and the strength of your injury claim. You should get any lien agreement in writing, notify your attorney early, and understand the financial and timing risks before relying on lien-based care.

What is a medical lien or letter of protection (LOP)?

A medical lien or letter of protection is an agreement between you and a medical provider under which the provider agrees to give treatment now and defer payment until your personal injury claim is resolved (settlement or judgment). The provider is typically paid out of the proceeds of the claim. Providers may record a lien, place an account hold, or rely on your attorney to protect their interests. These arrangements are common in accident cases where the injured person lacks health insurance or cash to pay up front.

How lien treatment commonly works in Colorado

Provider agrees in writing (LOP) to treat you and to pursue payment from your eventual recovery. The document should state the terms: which services are included, what portion is liened, and how fees will be calculated.
The provider may place a lien on any recovery or file a notice of lien. In many cases the provider relies on your lawyer to protect payment at settlement.
If you settle without addressing the provider’s claim, the provider can pursue collection from you or seek to enforce its lien rights against the settlement proceeds.
Some providers will not accept liens for certain treatments (e.g., emergency room care or major surgery) or will limit the amount and length of treatment on lien.

How to find doctors and facilities in Colorado that will treat on lien

Talk to personal injury attorneys. Many attorneys maintain lists of local providers (orthopedists, pain specialists, physical therapists, chiropractors, imaging centers) who commonly accept liens or LOPs. If you do not yet have an attorney, call a few injury firms and ask if they can refer providers even if you do not retain them.
Call hospitals’ financial/charity or billing departments. Some hospital systems and urgent care centers will consider lien arrangements or deferred billing for personal injury patients. Ask to speak with the business office and explain your situation.
Contact specialty clinics directly. Orthopedists, neurosurgeons, orthopedic urgent care clinics, pain-management clinics, and chiropractic offices commonly accept liens for accident injuries. Ask specifically whether they accept medical liens or letters of protection and what documentation they need.
Use patient or legal directories. Search for Colorado providers who advertise “personal injury,” “workers’ compensation,” or “letters of protection.” Follow up by phone to confirm current lien policies.
Ask provider billing staff key questions. Ask: Do you accept letters of protection (LOPs)? Do you file liens? What paperwork do you require? What portion of billed charges are typically accepted? Do you require an attorney’s guarantee?

What to get in writing

Never rely on a verbal promise. If a provider agrees to treat you on a lien or by LOP, get a written agreement that includes:

Exactly which services and dates are covered.
Whether the provider will file a lien and how (notice to the insurer/attorney, recorded lien, etc.).
How charges will be calculated (full billed charges, a reduced rate, or reasonable/usual charges).
Any deadlines for payment after settlement or judgment.
Whether the provider will continue to treat if your attorney is not retained or if your claim’s perceived value drops.

Steps to protect yourself and the provider

Inform the claims adjuster and any attorney you hire about all providers treating you on lien. That helps ensure providers are paid from any recovery instead of you being left with surprise bills.
Keep clear records. Keep copies of LOPs, bills, medical records, and communications with providers and insurers.
Do not sign a global release before resolving provider liens. If you sign a release that resolves the defendant’s liability without addressing medical lien claims, providers may sue you personally for payment.
Ask your attorney to protect liened providers at settlement. Attorneys can disburse funds at closing or negotiate reduced payments to lien holders to permit settlement.
Follow up on lien filings and deadlines. Providers must comply with any Colorado procedural requirements to perfect or enforce liens; if you see a provider fail to act, encourage them to get advice or involve your attorney.

Who is most likely to accept liens?

Smaller clinics and offices that regularly handle personal injury work — outpatient orthopedics, chiropractors, physical therapy centers, and certain imaging centers — are often more willing to treat on lien. Emergency departments and major hospitals sometimes accept liens but may require stronger assurances. Surgeons may accept lien treatment for evaluation but often require a retainer or payment plan for major procedures.

Costs, discounts, and typical outcomes

Providers accepting LOPs may charge their full billed rate, but many accept a significant reduction when they receive a portion of a personal injury recovery. Common outcomes include the provider accepting a negotiated percentage of billed charges or a fixed discounted amount at settlement. Expect negotiation between your attorney and medical providers unless the lien is clearly perfected and has priority.

Common pitfalls and red flags

No written LOP or unclear language about which care is covered.
Provider refuses to say how much of the billed amount they will enforce.
Provider will not communicate with your attorney or refuses to file or perfect a lien.
You sign a settlement release that does not specifically address medical liens.
Provider’s billing appears unusually high with no explanation or discount policy.

When to hire a Colorado personal injury attorney

Get an attorney if: you have serious injuries, likely significant medical bills, disputes about fault, or multiple lien holders. An attorney can negotiate with providers, protect lien interests at settlement, and reduce your personal exposure to unpaid medical debts. If you cannot afford private counsel, contact local legal aid or bar association referral services for low-cost options.

Resources

For Colorado statutes and general state resources, see the Colorado General Assembly’s statutes page: https://leg.colorado.gov/colorado-revised-statutes. For help locating attorneys, use the Colorado Bar Association referral service or local county bar referral websites.

Disclaimer

This article is for general information only and does not constitute legal advice. I am not a lawyer. Laws change and every situation is different. Talk to a licensed Colorado attorney about your specific facts before making decisions about treatment, releases, or settlements.

Helpful Hints

Ask providers directly: “Do you accept letters of protection or medical liens for personal injury cases?”
Obtain a clear, written LOP that lists the treatments and terms before receiving non-emergency care.
Keep all appointment notes, bills, and LOP copies in one folder for your attorney.
Tell any provider treating you about every LOP or lien so they can coordinate billing and avoid duplicate charges.
Do not sign a full release without confirming how liens will be paid.
If you cannot find a provider who will accept a lien, ask clinics about reduced-rate plans or payment plans instead.
Contact multiple providers; flexibility varies by specialty and office budget.
Early legal advice can increase the number of providers willing to treat on lien.