But we’ve seen what really happens when lawmakers legislate without understanding the mechanics. They don’t just “reform” a system—they fracture it. And the people who pay the price? Patients, providers, and the very healthcare infrastructure that personal injury cases rely on to function.

In this new regulatory environment, one thing is clear: doing it yourself is no longer an option. Providers can’t afford to manage their own liens. Plaintiffs can’t afford missteps that delay care or jeopardize recovery.

That’s why independent servicing models matter more than ever—and why Gain was built from day one to deliver exactly that.

What Is Independent Servicing—And Why Should You Care?

Let’s start with what it’s not. Independent servicing isn’t just software. It’s not a tech layer tacked onto old habits. It’s not a one-size-fits-all “platform.”

At Gain, servicing means full-cycle lien management, from intake to enforcement, backed by systems, oversight, and operational controls that are purpose-built for personal injury. We’re not just a financial resource. We are a third-party servicer that operates independently from the healthcare provider and law firm.

That independence is critical. Here’s why:

• No bias. When providers service their own liens, they’re exposed to case outcomes, policy limits, and attorney influence. With Gain, those touchpoints are strategically managed.
• Independent by design. We separate the financial administration from clinical care and legal strategy—giving all parties confidence in the integrity of the process.
• No guesswork. We bring structure, documentation, and compliance rigor to a part of the revenue cycle management space that’s been overlooked for too long.
  
  

This Isn’t Just Rev Cycle. It’s Real Risk Management.

Let’s be honest: most PI revenue cycle management looks nothing like commercial payer cycles. That’s a problem.

With Medicare or commercial insurance, providers know the playbook—coverage rules, appeal timelines, payer portals, audit triggers. But in personal injury, the variables multiply: legal strategy, litigation timelines, lien negotiations, insurance policy disclosures (or lack thereof).

You can’t manage that risk with spreadsheets and good intentions.

At Gain, we bring the same discipline you’d expect from a top-tier billing service for commercial payers—but tailored for PI:

• Custom intake and eligibility protocols
• Transparent case tracking
• Data-driven decisioning on whether to accept new cases
• A deep understanding of case values and appropriate reimbursements
• Built-in controls for write-offs, reductions, and bad debt risk
  
  

Most important? We don’t just hand providers a platform and tell them to figure it out. We do the work.

Post-Reform, Compliance Isn’t Optional

In Georgia, we saw firsthand what happens when legislative assumptions override operational insight. New disclosure rules, caps, and evidentiary restrictions have already started to chill provider participation and squeeze reimbursements.

In Texas, SB 30 threatened to follow Georgia’s lead, introducing mandates around medical record disclosure and billing practices that would have further complicated an already fragile system. While the bill ultimately failed, it did so by a narrow margin.

For providers servicing their own liens in this environment, the risks are real: increased scrutiny, operational confusion, and potential noncompliance.

Independent servicing protects you. It creates an operational firewall that ensures your revenue cycle practices align with evolving legal standards. And it gives you the documentation and defensibility you need if bills are challenged or scrutinized in court.

We’re Not a Platform. We’re a Partner.

Plenty of companies are trying to pivot into “PI solutions” right now. Some have slick tech. Some have call centers. Few have both. And almost none have the operational depth to manage risk and deliver results at scale.

Gain does. We’ve been building toward this moment for years.

• We work with top-tier healthcare providers across the U.S.
• We service millions of liens with full audit trails and real-time performance metrics.
• We help our clients avoid bad cases before they end up on the books.
  
  

And we do it without ever compromising the independence, transparency, or patient care standards that make this model work.

Final Word: You Don’t Want to DIY This

Tort reform isn’t slowing down. Whether you’re in Georgia, Texas, or one of the next states in line, you need a partner who understands both the letter of the law and the realities of PI.

Gain is that partner. We don’t just talk about compliance—we operationalize it. We don’t just say we reduce risk—we show you where it’s hiding. And we don’t just give you tools—we deliver results.
If you’re still trying to navigate this landscape alone, it’s time to stop. You can’t afford to do it yourself.

The post Don’t Do It Yourself: Why Independent Servicing Models Matter in a Post-Reform Era appeared first on Gain Servicing.

Your attorney should help you negotiate with the insurance company to get the best settlement possible for your case. There are a few things you can do to get the insurance provider to increase the amount it offers you.

Have Evidence to Back up Your Claim
Make sure to keep all of the documentation. An insurance company is unlikely to pay you anything if you don’t have documentation to back up your claim. You can dramatically increase your chances of getting paid by presenting the company with all the details of the accident, including the police report, your medical records and your insurance policy. Getting all of your documentation to your attorney, is the first step towards negotiating a settlement.

Your attorney can also have a paralegal do some research to see what the insurance company paid out in cases similar to yours. For example, if the company is offering you $50,000, but has paid out $150,000 in several previous cases, you can use that information to strengthen your case and increase your settlement amount.

Aim High With Your Request
One of the first rules of negotiating is never to lead with the amount you hope to get. Instead, request an amount that is anywhere from 25 to 100 percent higher than the sum you wish to receive. If you start by telling the insurance company the minimum amount you’ll accept, things can only go down from there. When you do make a high request, don’t do anything that will let the insurance company know what the lowest amount is that you’ll accept. You want to keep as much negotiating power on your side as possible.

Don’t Take the First Offer
Since you need money, it can be exciting when the insurance company responds with an offer, even if that offer is much lower than what you wanted. The second rule of negotiating a settlement is never to take the first amount offered you. Just as you requested an amount that is higher you actually anticipate, the insurance company’s first offer is actually lower than what they are prepared to pay you.

Be Patient
Insurance companies want to drag out the settlement, as they know most plaintiffs will cave in early and settle for less because they need the money. As mentioned above, the first offer is always low and you need to give your attorney time to get the right settlement. You should wait for your attorney to tell you that it’s fair settlement. Bottom line – make sure your mindset is set to be patient.

Find Funding to Tide You Over
You do have funding options to help you pay bills while you wait to get the best settlement offer possible. For example, pre-settlement funding is available and can be used to pay any of your bills. A non-recourse funding option, pre-settlement funding is not a loan and you only need to pay the money back if you win your case. Often, funding amounts are between 10 and 15 percent of your expected settlement.

Talk to your attorney to learn more about how to negotiate with an insurance company and to see if pre-settlement funding is the right choice for you. Cherokee Funding can walk you through the application and get your money to you within 24 hours of approval. Contact us today for more details and to apply.

The post 5 Ways to Get a Better Settlement appeared first on Gain Servicing.

Gain’s personal injury case management dashboard for attorneys makes case status updates a breeze as you go about your normal routine of requesting treatment for your clients, downloading documents, or getting an instant payoff request.

As soon as you log in, the FREE Gain Attorney Portal automatically shows and color-codes those cases for you that are in need of attention without having to pick up the phone or respond to an email, preventing those calls and emails from coming to you in the first place.

When you see a yellow, orange, or red case status appear, all you need to do is click on that case status and select the new status. And that’s it—you’re done!

You won’t receive any emails or calls about the case status because you’ve just provided everything you need to. If the status of a case has not changed, you can even select the same status to indicate there has been no change.

Gain’s personal injury portal is free, easy to use, and available to all personal injury attorneys. For more information, request a demo with our experienced team. If you’re an attorney, you can sign up for free.

The post Eliminate Status Update Calls With Portal From Gain appeared first on Gain Servicing.

Physicians and medical practice executives can find it difficult to manage cash flow, especially amidst the ongoing concerns surrounding COVID-19 and as elective surgeries and other lucrative procedures continue to be put on hold. Cash flow difficulties compound when medical services are provided to personal injury patients on a Letter of Protection (LOP) when payment from settlement can take years to receive.

Many practices attempt to handle LOP account balances in-house but LOPs are challenging for staff as practice management systems are not equipped to handle the complexities surrounding LOPs, including necessary and proactive follow-up measures with attorneys.

The downside, of course, is that cash flow takes a hit when LOPs are not managed properly and go unpaid. Since an LOP states that you, the medical provider, are agreeing to await payment from future settlements awarded to the patient/attorney, you can expect anywhere from six months to seven years before the practice realizes this revenue. Also, at the time of payment there may be reduction requests if the financial outcome of the legal case was not as expected. This can pose a serious risk to your payment. In response, some medical offices retain a paralegal or develop an underwriting department to screen the personal injury cases prior to seeing patients, all of which can be time consuming, costly and still result in unpaid LOP account balances.

LOP Financing Options: Third-Party, In House, Gain Servicing

Many practices sell their LOP account balances at a discount to lien financing, or medical funding, companies. This provides the practice with immediate cash flow and offloads the work of tracking, managing and collecting on LOPs, but it comes with a tradeoff. Not only does the practice give up control of the process but having a third-party manage your LOP accounts receivables (AR) can come at a severe cut in profit depending on the bid amount of the financing company on your AR balances.

But, if managed in house, medical providers lack options to increase revenue and decrease time between service and payment for personal injury treatments.

A viable alternative is to consider a data-driven financing partner, like Gain Servicing. Our technology platform is backed by artificial intelligence and data from thousands of personal injury cases – intelligence we are able to pass along to our medical partners, resulting in fewer write-offs and more paid-in-full LOP balances.

Additional, unique benefits of Gain Servicing:

• Automated LOP tracking – no more manual processes or workarounds
• Optimized revenues – our AI-powered platform enables us to compare balances and case data points to help you get a better return
• Business intelligence – detailed reporting and analytics show you how well our system is doing for you
• Referral source analysis – know exactly how patients are choosing your practice through the identification and tagging of attorney referrals
• White label options – our team can act as badged resources for your practice while collecting on LOPs, creating a consistent patient and attorney experience with your practice

In the Gain Servicing model, you benefit from our tools and technology, experience, expertise and optimization of LOPs without the risk you had previously been assuming by treating personal injury patients on LOPs and not having the right systems, processes, procedures and people in place.

A Newfound, Viable Source of Revenue: LOPs

With a financing partner like Gain Servicing, practices can open their doors even wider to personal injury and workers’ compensation patients.

Marketing for these types of patients is relatively simple. Begin first by letting physicians know that they can bring their personal injury and workers’ compensation patients who are uninsured or underinsured to your facility. Many orthopedic surgeons and pain management physicians are already treating or being approached by attorneys to treat these injured patients. You can also notify your local personal injury attorney offices or local litigation groups who legally represent potential patients of your willingness to accept their clients on a lien or LOP.

In Closing

Communication with patients and attorneys is an ongoing requirement when dealing with LOPs; otherwise, it is possible they may settle the case without paying your medical bill. A technology-driven, experienced financing company, like Gain Servicing, takes on the role of an entire collections department while additionally providing LOP-specific tools, expertise and processes. Namely, LOP receivables do accumulate and age well beyond 120 days, and if not working with a medical-legal funding company, like Gain Servicing, you will need to allocate valuable resources to keep up to date and track your LOP accounts.

When evaluating alternatives to expand your reimbursement portfolio, accepting personal injury and workers’ compensation patients on LOPs is a sound business decision and requires minimal investment to significantly increase patient volume. You can reasonably expect that by opening communication with local attorneys, you will see consistent patient referrals, especially if you partner with an expert like Gain Servicing and have an efficient process surrounding LOPs.

If your practice has already been treating patients on LOPs and you need to increase your cash flow now, seek an experienced partner to monetize that patient volume through lien purchasing or servicing. Gain Servicing has several different options available, and we can customize a solution that will result in the greatest return on investment for your practice.

More About Gain Servicing

Gain Servicing specializes in the financing and servicing of personal injury and workers’ compensation patient receivables.

Gain Servicing is a wholly owned subsidiary of Cherokee Legal Holdings, a medical-legal funding company headquartered in Atlanta, Georgia. For over 10 years, we have financed existing third-party liability accounts from patient care that has been provided at healthcare facilities and medical practices across the U.S. We provide the underwriting and up-front screening, as well as process the paperwork and conduct the necessary follow-ups with attorneys after procedures are complete. We pay medical providers for their patient care, assuming the risk while providing immediate cash flow to the practice. Our goal is to increase healthcare organizations’ cash flow now while seamlessly allowing providers to do what they do best – provide care to those in need.

Gain Servicing is the go-to solution for medical practices providing quality care to the injured, underinsured and uninsured.

The post How To Increase Cash Flow From Letters Of Protection Cont’d appeared first on Gain Servicing.

The post How To Increase Medical Cash Flow From Letters Of Protection appeared first on Gain Servicing.

As a direct funder, we cut out the middleman to save you time, money, and to help you get funds to cover what you need to cover now.

The Difference Between Direct Funding and Brokers
Chances are, if an individual is in need of a pre-settlement advance, sometimes referred to as a lawsuit cash advance. the situation is dire. When you need funds, waiting 48 hours, or even 24 hours, can sometimes be too long.

So, what are the benefits, and the importance, of using a direct funder instead of a broker? For starters, it streamlines everything. Just like anything else, the more people you add into an equation, the more convoluted things get, not to mention the more expensive. Everyone expects to be paid for their efforts, even if they are nominal to your cause.

Who Are Lawsuit Brokers?
Here’s a simple scenario:

Say a client has hired an attorney to bring a lawsuit to court. A broker will help that client find an investor who can help with a pre-settlement advance on terms that work for that particular client.

This is how the broker process breaks down:

• Lawsuit funding brokers speak with the client
• They gather all of the necessary materials of the case
• They research to find lawsuit funders
• They submit the case to several funders to see who is interested in the case
• They monitor the status of the case, including fielding calls and questions from the client
• They forward the funding agreement to both the client and the attorney, when and if there is one
• They field all questions regarding the contract and the terms of funding, which often includes a lot of additional back and forth among the funding company, the client and the client-attorney
• They send the signed contract back to the funding company from the attorney and client
• Lastly, they confirm when the client actually receives the money

If it sounds like a lot of back and forth, that’s because it is.

And, brokers expect to be paid every step of the way for their efforts. Their fees are added on to the amount of the contract, which can range, on average, to be anywhere from 15 – 20 percent.

I would be remiss not to mention the clients in these cases are probably going through one of the worst events of their lives. They have, in fact, just been in an accident after all.

For legal funding clients, the amount owed back on a cash advance is not calculated on the funding the client actually receives, but on the cost of the contract, which is also why legal funding is not classifiable as a loan. For all intents and purposes, it is an investment. Broke, s on the other hand, charge a portion on top of those funds – they are paid upfront by the funding company and this amount is added to the overall funding amount received by the client – adding unnecessary costs to the plaintiff when, as direct funders, we gather all of the necessary information from the client and attorney, submit it to underwriting and have an answer, in most cases, within the same day. The best outcome for the client and attorney is to fund directly, cutting down on both the time and expense of this process.

How the Direct Funding Process Works
I can only speak for Cherokee Funding when I say this, but the application process is very simple; although, we only fund clients after speaking with their attorneys first. There is never an employment verification or a credit check because the funds we provide are based solely on the facts of the cases – and our contracts are written to protect plaintiffs in the event their cases do not settle.

We are a member of the American Legal Finance Association (ALFA), which provides a layer of comfort for our clients; they know they are working transparently and with the industry’s best. At Cherokee Funding, we take pride in our membership with the ALFA. We are consistently proving our adherence to industry best practices, including the way in which we issue cash advances, and how we go about recovering repayment when applicable.

Closing Thoughts
Cherokee Funding has provided legal funding to tens of thousands of cases by offering the best possible combination of funding solutions to meet almost any need out there.

If you have recently been in an accident and have found yourself standing at the crossroads of considering whether or not you should work through a broker or directly with a direct funder, I hope this provides you with some clarity during what I know to be an otherwise confusing and stressful time.

If you have any additional questions about lawsuit brokers, or legal funding in general, please leave me a comment below and I’d be happy to get you an answer and, I can always be counted on to give my opinion, too.

The post Direct Funding: The Process, The Key Players and Why You Should Go Direct When Possible appeared first on Gain Servicing.

From intake to underwriting, to uploading documents and generating the acknowledgement of purchase and the notice of liens, to case updates, additional treatment, settlement and collections, there are critical, and careful, steps that must be taken along the way to successfully service a medical lien.

Medical and legal funding, and how cases are processed from intake to underwriting and case management, needed follow up care, case updates, settlement and collections can have profound ramifications if they’re not meticulously documented.

At Gain, we are truly the anomaly when it comes to our funding practices. Instead of funding or purchasing liens and becoming a collections company (as many of our competitors are), we offer a full array of legal and medical funding solutions to provide needed funds and medical care. We also understand case valuations and carefully assess the probability of the plaintiff receiving funds, the attorney being paid, and medical bills being reimbursed, and share this critical insight with those who work with us.

Our high degree of customer service and systems enable the large-scale servicing of medical liens and also allow attorneys to focus on maximizing case values while knowing their clients’ liens are being held and serviced by a company that can approve additional funding as needed. During litigation, attorneys have one source for bills and notes, and at settlement they have one source to consolidate payoff information. This saves significant time and money. One source of underwriting also gives cases a higher probability of not being overfunded, thus leaving all parties satisfied.

An Empowered Process

Our process is steeped in expert resources and sophisticated systems, including intake specialists, underwriters, case managers, risk managers, and medical billing specialists, to name a few. All of whom have very specific functions to fulfill within a highly-defined workflow.

Case managers, for instance, are responsible for coordinating the care of injured clients across a large array of healthcare professionals. They coordinate resources and create flexible, convenient and cost-effective options for injured individuals on a case-by-case basis to facilitate quality, individualized treatment. They also establish goals, and help patients get the care they need by assisting with scheduling appointments and communicating patient progress.

These resources can explain medical conditions and treatment plans to the patient, family members and their attorneys. They’re reliable experts with incredibly relevant experience, and they usually end up being one of the closest confidants to plaintiffs during litigation and throughout treatment.

The one key denominator, as far as job functionality goes, across all of our team is this: we all share in the responsibility to improve day-to-day operations and services to ensure a best-in-class experience for what is easily one of the most difficult times for our clients – plaintiffs involved in personal injury lawsuits.

Continuous Investment

Two recent Gain reviews by our employees said this about our investment in technology:

“Advice to management: continue to invest in your technology platform. It is the best in the industry and [it] gives us a significant competitive advantage every day.” – Underwriter

“[Gain has continued] making significant investments in systems to help make everyone’s live[s] better.” – Anonymous Employee

Before legal and medical funding, plaintiffs involved in personal injury lawsuits had nowhere to turn for financial relief while they waited for their cases to settle. If they did not have enough in savings, family members to turn to or personal credit cards, they were simply out of luck. Some cases even take years to settle, meanwhile medical expenses, lost wages, and daily living expenses continue to mount.

Providing a solution – a means to an end – for plaintiffs, while being a strong partner to law firms and medical practices was how Gain got its start. To continue to be the best resource to all parties involved, we invest, and reinvest, in our process, technology and people. It’s not cheap, in fact it’s the biggest investment we make year-over-year, but it’s paying off in dividends for the people we help every day.

Because of our continuous investment, proudly:

We Are the Highest Rated Funding Company

Now there are options when it comes to choosing a funding company, and we make it a priority to provide the best service and offer the lowest fees—because we firmly believe in the importance of giving personal injury plaintiffs financial breathing room. We also make sure to listen to their changing needs – which is why we started offering Same Day Cash Advances™.

We Have the Best Reputation in the Industry

Gain’s reputation is unsurpassed for being 100 percent transparent. We are a proud member of the American Legal Finance Association (ALFA), Americans for Responsible Consumer Funding (APA) and a founding member of Americans for Patient Access (APA), which set the gold standards in legal and medical funding and assure that patients have access to needed medical care.

We are also an active sponsor of the Georgia Trial Lawyers Association (GTLA) and numerous other state associations including FJA, SCAJ, STLA, AAJ, TTLA and more. Creating meaningful partnerships and joining organizations on their missions to regulate and better service medical and legal clients is a top priority for us.

Our industry is not static, and neither are we.

To stay up-to-date on what we’re working on, please be sure to check out our blog.

The post How We Process and Continuously Invest In the Servicing of Medical Liens appeared first on Gain Servicing.

How Same Day Cash Advances Works

The people applying for Same Day Cash Advances are doing so because they are in urgent need of funds. This is especially true for those clients who have recently been in an accident and are awaiting settlement.

More often than not, these same people are unable to continue working due to their accident, and regular reoccurring monthly bills like heat, hot water, rent, and electricity are adding up. And this is exactly why we started offering Same Day Cash Advances. It is intended for clients in need of funds quickly, which is why operationally we have established a process that does not require a credit check, nor is there a fee to apply.

Same Day Cash Advances applies to funding needs up to $2,500.00 against motor vehicle accident cases. Completed applications must be received by 2:00 PM Eastern Standard Time in order for same day funding to apply. It is also important to note that both the applicant and the applicant’s attorney must sign the accompanying contract in order for the funds to be sent out.

We encourage those applying to talk with their attorney’s office before applying, not only for guidance but to make sure they are available to receive and execute the contract on the plaintiff’s behalf. Cash advances for all other case types are usually funded within 24-hours of receipt of the completed application, if not the same day.

Same Day Cash Advances does not apply during bank and other federally recognized holidays.

Same Day Cash Advances: Step-by-Step Process

The Same Day Cash Advances process starts with our application, which can be accessed here, or plaintiffs can call 855-394-2274 and complete the application by talking with one of our intake specialists.

The application form is simple and designed to expedite the process for the fastest possible service to our clients. We also do not run a credit check for this particular application.

The completed application is assigned to a Gain Intake Specialist who will guide the plaintiff through the initial steps, including gathering information from the plaintiff:

• Contact information, including full name, phone number, and date of birth
• Attorney’s contact information
• The amount of money being requested
• The name of any prior funding company and amount received, if applicable

After the application has been received, Gain will contact the plaintiff’s attorney to complete the underwriting process, which will include:

• A copy of the police and/or accident report, and
• The name and contact information of the insurance carrier, as well as the policy limits

If approved, Gain will then email the plaintiff and the attorney a contract for signature. Money is sent after the contract has been signed and is received the same day, so long as the contract has been signed by the attorney’s office by 4:00 PM EST.

Clients requesting Same Day Cash Advances must also have an established bank account to receive the electronic funds.

Why 24-Hours Matters

Same Day Cash Advances was created out of the countless real stories we encountered of mothers and grandmothers and primary caretakers who have had electricity or gas shut off around them because they couldn’t afford the bills rolling in. Or, the families we have known who have depleted all that is in their refrigerators and were forced to make hard choices about what to pay for and if that included food or not. It’s for the people we’ve known who have faced vehicle repossession or potential eviction.

We’re proud to say that no other legal funding company comes close to supplying cash advances this fast, this simply, or this affordably in legal funding.

And although there is no impact on the case outcome, the impact is directly felt by those that matter most the plaintiffs in need of financial relief while they continue to wait for a fair settlement. Living expenses don’t stop, even when an accident happens, and that’s where Same Day Cash Advances comes in.

We have designed our operational process around offering Same Day Cash Advances to require limited documentation, which allows for a quick response and turnaround time. It’s all about plaintiff satisfaction and relief. For attorneys and case managers, this means saving valuable resources from respectfully and kindly having to field the real issues people are facing, and it gets it to the people who can help and that’s us.

The post Why Same Day Approval Funding Matters in Personal Injury Settlements appeared first on Gain Servicing.

In our experience, doctors wish to provide high-quality medical care to as many patients as possible. Worrying about contracts, reimbursement rates and collections from a variety of payor sources is not the reason most doctors went to medical school, yet the revenue cycle management side of the business is essential to operating a successful practice.

Most revenue cycle management companies are good at contracting with a variety of payor sources and collecting patient payables. But for patients who have been injured in an accident and who do not have adequate healthcare coverage but need medical attention, these bills are more complex.

For doctors providing care to personal injury victims, LOPs are an alternate form of payment. Seeing patients regardless of payor source is an honorable pursuit. LOPs are signed by both the patient and the attorney representing the patient at the time of treatment. They simply state that upon resolution of the personal injury case, the balance of the medical bills will be paid through the attorney escrow account. In return, the provider agrees to provide treatment.

In essence, a personal injury letter of protection allows victims to receive the care they need – care they otherwise would not be able to receive – while also protecting healthcare providers.

The Key Issues Medical Providers Face with A Personal Injury Letter of Protection and Their Solutions

In today’s environment, a letter of protection is managed by medical providers and law firms or sold outright. But this is not the wave of the future. Insurance defense and various state legislatures are increasingly scrutinizing the traditional sale of medical receivables, passing legislation prohibiting or seriously limiting this option.

Gain is the future of letter of protection medical lien servicing for uninsured and underinsured patients in need of medical care. Gain provides an independent, SaaS-based, AI-enhanced, third-party servicing platform to separate medical providers from the potential for conflict of interest, biased medical opinions, and financial interest in the outcome of the case while servicing these receivables rather than purchasing them.

This allows patients to receive needed medical care without the undue pressure that traditional medical funding can put on the case settlement. By servicing liens on behalf of medical providers. Gain also provides a variety of financial solutions that maintain the doctor’s independence.

One issue for medical providers holding their own patient medical liens is that insurance defense counsels have made them one of their primary targets. Some of their common tactics include:

• Operating a “playbook” designed to trap providers into appearing that there is a conflict of interest, that their medical opinion is biased, and that they are “investors” in these lawsuits.
• Examining communication, including text messages, emails, phone logs, and more, between providers and attorneys for communication regarding insurance policy limits, case values, ongoing case updates, settlement influence, negotiations, case involvement, and insurance opt-out requirements.
• Looking for the separation of patient and clinical records and bringing in forensic medical billing experts to search for dual charge masters, varied billing, upcoding, charges that are beyond usual and customary, and more.

Here are some of the additional challenges healthcare providers accepting medical letters of protection face and the solutions Gain has created to address them:

Operational

Challenge: Practice management systems (PMSs) and revenue cycle management (RCM) platforms are not designed to track or manage LOPs, including referral source analysis. As a result, medical providers are often forced to create manual, time-consuming workarounds to track LOPs.

In our experience, it is extremely difficult to avoid instances that result in write-offs when using these types of workarounds. Additionally, there is often a large volume of receivables without due dates.

Solution: Gain has designed personal injury case management software to automate and optimize the tracking of lawsuits tied to LOPs. Capabilities include notice of service, all needed filings, automated case updates, automated LOP tracking, referral source analysis, revenue optimization, reporting and analytics, and additional business intelligence to provide real-time status updates.

Communication

Challenge: For medical providers, rather than having a single point of contact or payor source, personal injury patients require complex communications with case managers, paralegals, the patient, attorneys, and third-party liability carriers. The management of these communications alone is not easy and is not readily available in current RCM, EMR, or Billing Systems. Failure in these areas leads to higher charge-offs.

Solution: It is essential for holders of LOPs to be in constant communication with attorneys, paralegals, and case managers to obtain underwriting information, assess case characteristics, receive case updates, negotiate settlement amounts, and perform collection activities. Liability carriers also need to be contacted in certain circumstances. Gain’s practice is designed around and specializes in these critical forms of LOP communication needs.

Insurance Defense

Challenge: Insurance defense attorneys are attacking medical providers who hold LOPs and communicate with attorneys to attempt to show bias through the discovery of case communication between attorneys and doctors, the exchange of case estimates, policy limits, and more.

They often claim charges are excessive and that professional opinions are biased. This also leads to high costs for medical providers due to legal responses, objections, discovery, and longer depositions. Medical providers, PMS, and RCM platforms are not equipped to object to discovery requests or segment any of this information to avoid these potential objections.

Solution: Maintaining healthcare provider integrity and unbiased medical opinions, as well as eliminating the financial interest in the outcome of a case, are all challenges that Gain solves for medical providers.

Legislative

Challenge: Various legislatures have attempted to eliminate traditional medical funding in order to force healthcare providers to hold liens and then have insurance defense attorneys attempt to show the bias outlined above.

Solution: Nationwide lobbying efforts are key to maintaining patient access to quality medical care. Gain is a founding member of Americans for Patient Access (APA), a best practices organization committed to maintaining access to quality medical care for all patients regardless of payor or source. Lien servicing is the future, and Gain is the industry leader.

Letters of Protection Servicing Options for Medical Providers

There are several servicing options that Gain has evolved to address the most pressing needs of medical providers when it comes to LOPs:

• Medical Funding: Gain provides cash advances to patients, so you receive payment at or near the time of service rather than waiting until cases are resolved.
• Medical Lien Management Services: Holding medical liens in-house poses substantial risks to your practice. Gain offers comprehensive lien management services to transfer the responsibility for negotiation and collection from you to us.
• Unpaid Medical Lien Purchasing: Gain will purchase your unpaid medical lien receivables at the highest prices to take them off your books and give you an immediate cash infusion.

Personal Injury LOPs serve a critical need for victims. They are traditionally serviced in-house by a medical provider, through a law firm, or sold to a medical funding company. Each of these options is outdated, similar to the situation Kodak and Polaroid faced when they knew that digital film was coming but chose not to cannibalize their own businesses, instead going bankrupt.

At Gain, we see the future and are willing to cannibalize our own business for the benefit of patients, doctors, and the legal community. It is paramount that the victims in these cases have access to the medical care they need. A trusted outsourcing partner can allow you, the provider, to focus on treating more patients and getting great outcomes for them.

Our holistic approach to servicing, including technology, people, and processes, is proven to deliver higher reimbursements at a lower cost. Let us help you help your patients.

If you are a medical provider with questions about medical lien servicing, please get in touch with us. We would love to discuss your practice, LOP challenges, and our solutions.

The post The Opportunity With Letters Of Protection For Medical Providers appeared first on Gain Servicing.

In a single personal injury case, there may be multiple lienholders. Health insurance companies, for example, may issue a lien against the at-fault party to recover any money they spend on treatment as a result of an accident. This is known as subrogation, or the substitution of one person or group by another in respect to a debt or insurance claim, accompanied by the transfer of any associated rights and duties.

Insurance providers with subrogation claims can seek repayment from plaintiffs settlements; although, it is important to note, some states prohibit subrogation clauses altogether in health insurance policies. Medical providers who provide medical treatment may also issue a lien on a case and provide services under a letter of protection (LOP), which states that the balance of all unpaid medical bills will be paid upon resolution of the personal injury case.

In short, any group, organization or entity that provides services on contingency to a plaintiff, no matter what they are, can become a lienholder in that plaintiff’s case.

Lien Confirmation

Because there can be so many lienholders in an individual case, it is important for lienholders to confirm their lien agreements with the plaintiff’s attorney. Even after a lien agreement has been signed and put on file, which means something different for every firm, it is important for lienholders to confirm their liens and to follow-up on the case regularly. Because personal injury cases can take months or years to settle, proactive and diligent lien management is critical.

Not only can there be dozens of lienholders in any one case, any one plaintiff attorney can be working on a number of personal injury cases. And, despite digital transformation efforts within the industry, oftentimes, plaintiff attorneys are still relying on paper filing, verbal conversations and outdated computer systems. Ultimately, it is up to the lienholder to follow-up on what they are owed. Often, a case may settle without all lienholders being properly informed of the settlement.

In brief, here is how lien confirmation works:

The lienholder confirms the attorney is a reliable escrow agent and that there is a legal agreement in place for the lien.

Within a few days or a week of services being provided, the lienholder confirms the following with the plaintiff’s attorney: the plaintiff’s name, the service provider’s name, the type of servicing (financing, surgery, etc.), the date services will be or have been provided, and that all of this information, i.e. the lien, is on the plaintiff’s file.

Confirming and tracking the status of a lien is essential to ensure proper recovery. As a lienholder, it is a good idea to create a regular follow-up schedule and to be diligent about confirming the lien is still associated with the plaintiff’s file.

At Gain, we have developed an AI-powered platform to track and manage all LOPs and liens. Because a lien can be arranged before services are provided, the lien is not officially in place until it is executed on all sides. Meaning, service providers can obtain written acknowledgement of their liens ahead of services being provided, whether that be medical services or funding to plaintiffs, but they do not technically have a lien until services are actually provided.

It is not uncommon for plaintiffs or service providers to change their minds or alter provisions of the services after a lien agreement has been verbally discussed, which is why confirmation and follow-up after the fact is necessary. A lien has been fully executed when service has been provided, for example the plaintiff has received treatment or has been advanced money.

Confirmation by phone and/or email can be simple examples are included below. Note: When calling an attorney’s office, be sure to note the date, time and who you spoke with.

Hi, this is [Name] from [Company/Service Provider] confirming that [Plaintiff Name] received [Service – Treatment or Funding] from [Company/Service Provider] following his/her accident on [Date of Loss]. Has this been notated as a lien on [Plaintiff Name]’s file?

Following a verbal confirmation, it is always a good idea to then send an email. You can let whoever you spoke with know that you will be following up with an email to the appropriate case manager, paralegal or attorney so that you and they have record of the conversation. Print records are paramount.

Hi [Case Manager/Paralegal/Attorney],
We provided [Plaintiff Name] with [Service Treatment or Funding] on [Date of Service]. Attached are the [Medical Bill or Financing Agreement] and signed lien agreement for your records.
Please reply to this email confirming that you have our lien on file.

Additionally, you can add a Read Receipt to the email you send, as well as send a confirmation by certified mail.

It may sound excessive, but effective lien management is an essential part of the personal injury case process. Best practices are not complicated, and diligence and good communication go a long way.

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