Medical Lien Packet PDF - Graham Lundberg amp Peschel 2025

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The document is a Medical Lien Packet that provides detailed instructions on how to file a lien for medical services rendered to patients with traumatic injuries. It outlines the legal framework under RCW 60.44, including the requirements for filing a lien, costs associated with the process, and necessary forms such as Notice of Claim and Satisfaction of Lien. The packet emphasizes the importance of timely filing and communication with insurance companies to ensure enforcement of the lien.

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Click ‘Get Form’ to open the Medical Lien Packet PDF in our platform.
Begin by filling in the 'Claimant' section at the top with your name and address as the health care provider.
Next, enter the 'Patient' details, including their name and address, ensuring accuracy for effective processing.
In the 'Tortfeasor' field, provide the name and address of the individual or entity responsible for the patient's injuries.
Fill in the 'Insurer' section with the insurance company’s name associated with the Tortfeasor.
Accurately complete the 'Date and Time of Accident' and 'Location of Accident' fields to establish context.
If known, include the 'Claim Number' from the insurance company; otherwise, you can note it as 'unknown'.
Describe the 'Nature of Injuries' using general terms without detailed medical codes.
Finally, sign the form in front of a Notary Public to validate your claim before submission.

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