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Tower Grove Lawyer
Tower Grove Lawyer, Attorney
Category: Personal Injury Law
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I am a chiropractor who is owed $7K for care provided to an

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I am a chiropractor who is owed $7K for care provided to an accident victim. We provided services, billed the 3rd party insurance who payed the patient and now the patient doesn't want to pay us. What advice do you have?
Thank you for your question. I will do my best to answer your question. Please note that this does not constitute legal advice as I do not know all the specific facts of your situation. We have not created an attorney-client relationship simply through this communication. Also, please be aware that these communications are NOT confidential or private, and are located on a public web site.

You have a couple of options here.

First, if you have sent the patient a number of bills but he has not paid, you can contract with a collections agency and turn his account over to that agency. You will need to pay the collections agency a fee but this is often the easiest way to ensure you will recover at least part of the money.

Second, you can file a lawsuit against the patient by yourself. This can even be a small claims suit since the jurisdictional limit in Georgia is $15,000. If the patient sought treatment but did not pay, you are almost guaranteed that you will win. The downside is that it will take up a little of your time to file the suit.

Third, you can retain an attorney to file a lawsuit against the patient. You have a good chance of recovery, but the downside is that you will have to pay the attorney.

Fourth, you can send a lien notice to the third-party insurance provider pursuant to O.C.G.A. § 44-14-470 et seq. The advantage of a lien notice is that the third-party is required to pay you before the patient receives any money. However, if the patient has already settled his claim with the third-party insurance and the third-party insurance has paid everything, it is too late for the lien notice to have any practical effect.

As for what you should do, it depends upon how much time and effort you want to put into recovery. If you just want to recover something but don't want to spend any time, I would contract with a collections agency. If you have time and want to recover everything, a lawsuit is likely the best approach.

Please let me know if I can clarify any of my remarks.
Customer: replied 3 years ago.

Small claims court is a viable option for me but collecting is probably going to be a challenge, based on what I hear.

Is there any language you can suggest in our letters to the patient that may provoke payment. Perhaps, about tax liability, fraudulent acts, etc?

Does the OCGA you sited require insurance companies to pay us directly? I didn't think that was an option for us in some cases.

As someone who has represented small businesses, I find the most effective letters give the patient a certain date to either pay the entire amount or enter into a payment plan. The letter should state that, if payment is not received by that date, you will file suit and will ask a court to garnish wages, etc.

Here are some good sample letters that are more geared towards collections, but start with a friendly letter and get progressively "meaner":

The lien statute I cited would allow you to recover in the event the patient filed suit later on, although it sounds like you could be too late if the third-party insurance has already made payment to the patient.
Customer: replied 3 years ago.

We did have a lien that was sent to the insurance company with the medical bills. They paid the patient anyway. Perhaps we are not adamant enough about payment coming to us? Perhaps our lien is out of date? Here is an example as attachment.

Attachment: 2013-08-19_153403_doctor_lien_back.doc

We send this to the 3rd party with the bills.

The language in that attachment will bind the patient but not the insurance company.

If proper notice was issued to the insurance company prior to any payments being made to the patient, then the insurance company is likely in violation of Georgia law. But if the only lien notice sent to the insurance company was the one you attached, it is not sufficient to bind the insurance company.
Customer: replied 3 years ago.

Last question:

to summarize; i must file a lien with the superior court prior to sending bills to insurance company. Upon sending bills I must provide copy of that lien. Do I need a seperate document to force the insurance co. to pay me instead of them? Where do I find such a document?

Thanks for your help, I appreciate it!

The insurance company should automatically pay you first, assuming the lien process was followed.

If the insurance company does NOT pay you, you can either 1) send a letter to the insurance company demanding they pay you immediately because the lien process was followed, or 2) file suit against the insurance company to enforce the lien.

However, I would make sure the lien process was followed. In my experience, insurance companies pay close attention to lien notices even when the process is not followed 100%.
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Customer: replied 3 years ago.

I asked you a question earlier this week about receiving payment from a chiropractic patient. i have come to find that your advice is not within the scope of the law. Chiropractors cannot file medical liens like you suggested. If you know otherwise please respond with new info.

I disagree with the information that you have received.

O.C.G.A. § 44-14-470 allows a "hospital, nursing home, physician practice, or provider of traumatic burn care medical practice" to perfect a lien.

O.C.G.A. § 44-14-470(a)(4) defines "physician practice" as "any medical practice, that includes one or more physicians licensed to practice medicine in this state."

If you are licensed to practice medicine, then you can perfect a lien under this statute.

This is a relatively new change to the law so your source could be using outdated information.
Customer: replied 3 years ago.

A chiropractor is not a medical doctor therefore does not have a license to practice medicine.

Here is the text from


Notably, it does not appear that the law (O.C.G. A. 44- 14- 470) allows a chiropractor’s office to file this type of medical lien unless the chiropractor’s office is part of a and “physician practice,” meaning part of a practice operated by physicians licensed to practice medicine in Georgia. If you have treated with a chiropractor on a “chiropractic lien” or, sometimes known as an “attorneys lien,” this means that the chiropractor may not have the same type of enforceable lien against the settlement itself, unless the chiropractor operates as part of a physician’s practice. However, a chiropractic lien is still a medical bill that the patient is responsible for, and the lack of a “medical lien” does not mean that a patient can ignore the chiropractic bill.


If you have further suggestions it would be appreciated.


I was unaware from your original question that you were not a licensed medical doctor. I assumed this based upon your language about patients and insurance.

You are correct that the patient is still responsible for the bill. As I indicated in my original answer, referring this patient to a collection agency or filing a small claims suit are your best approaches. I myself have represented a small dental office that has used both approaches in the past. Collections agencies are considerably easier than small claims suits but you will need to pay them a portion of anything you recover.

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