A new client signs on Monday afternoon. They were rear-ended four days ago, went to urgent care once, and have done nothing since because their health plan has a high deductible and they cannot afford to treat. If nobody on your team moves, the next entry in their medical chart may be weeks away, and the defense will call that silence proof that the injury was minor.
The goal of this checklist is simple: get the client in front of an appropriate treating provider who accepts a lien or letter of protection (LOP) within 48 hours of sign-up, and set up the paperwork so records and bills flow back to the file without chasing. Every step below is something a case manager, intake manager or lien coordinator can run without waiting on the attorney, with clear points where the attorney needs to sign off.
Hours 0 to 4: Confirm the Treatment Need
Before you call any provider, get the facts that tell you what kind of care the client is actually asking for. Start with a short structured call, not a free-form chat.
Intake call checklist
Ask and record: date and mechanism of injury; every body part that hurts now; any emergency room, urgent care or ambulance contact so far; current symptoms such as numbness, headaches, dizziness or trouble sleeping; any prior injuries to the same body parts; and what health coverage the client has, including Medicare, Medi-Cal or a Medicare Advantage plan.
Flag red-flag symptoms right away. Loss of consciousness, worsening headaches, loss of bladder control or new weakness in a limb are emergency-room issues, not lien-provider issues. Tell the client to go to the ER and document that you did.
Coverage check
If the client has health insurance, the attorney decides whether treating on a lien makes sense. California courts have allowed insured plaintiffs to treat on a lien and present the billed amounts, as in Pebley v. Santa Clara Organics, LLC (2018) 22 Cal.App.5th 1266, but that is a case strategy call, not a staff call. Government payers carry their own reimbursement rules; see our piece on Medicare Advantage plan reimbursement claims before you place a beneficiary.
Hours 4 to 12: Choose the Specialty
Match the specialty to the complaint, not to habit. A quick reference most offices find useful:
Neck and back pain, soft tissue: chiropractic or physical therapy, often with a primary treating physician overseeing care. Radiating pain, numbness, suspected disc injury: orthopedics or pain management, usually with an MRI order. Head strike, concussion symptoms: neurology. Shoulder, knee or wrist injuries: orthopedics. Anxiety, sleep problems, fear of driving: psychology or psychiatry.
Write down why you chose the specialty. A one-line note in the file ("radiating left arm pain, numbness in fingers; referred for ortho and MRI evaluation") helps the attorney later explain why the care was reasonable and necessary.
Client choice comes first
Give the client options and let them pick. The provider decision belongs to the client. Offer two or three providers that fit the specialty, location and schedule, and record which one the client chose. Never accept anything of value from a provider in exchange for sending clients; California law bars compensation for patient referrals (Bus. & Prof. Code, § 650), and the State Bar Act prohibits the use of runners and cappers (Bus. & Prof. Code, § 6152). Keep your relationships with providers strictly about scheduling, records and billing.
Hours 12 to 24: Confirm Lien Acceptance and Send the Paperwork
Do not assume a provider takes liens because they did last year. Call and confirm each time.
Provider call checklist
Confirm: the provider currently accepts a lien or LOP for this type of case; which specialties and services are covered (some offices take liens for visits but not for imaging or injections); the earliest new-patient slot; what documents they need before the first visit; who handles records requests and billing statements; and whether they accept e-signed lien forms.
Sending the lien or LOP
Use the firm's attorney-approved template. Never draft a custom LOP on the fly. Send it with the client's signed HIPAA-compliant authorization (the Confidentiality of Medical Information Act, Civil Code section 56 and following, governs what the authorization must say), a short referral note with the date of injury and body parts, and the claim and adjuster details if the provider asks. Calendar a follow-up call two hours later to confirm receipt.
Keep a lien log for every client: provider name, date the lien was sent, date acknowledged, and services covered. That log becomes the starting point for lien negotiations at settlement, when doctrines like the one explained in our article on the common fund doctrine and lien reduction may come into play.
Hours 24 to 48: Transport and the First Visit
Many placements fail here. The appointment is booked, but the client has no car because it was totaled, or they work shifts and cannot make a 10 a.m. slot.
Transport checklist
Ask the client directly how they will get there. Options include a family member, public transit, or a ride arranged through the provider's office if they offer it. Follow your firm's written policy on any transportation the firm itself provides, and have the attorney approve that policy. Send the client a text the day before with the address, time, parking notes and what to bring: photo ID, insurance card, any ER discharge papers and a list of medications.
Day-of confirmation
Call the provider's front desk after the appointment window closes. Did the client show? What is the treatment plan and visit frequency? Were any imaging or specialist referrals ordered? Log the answers the same day.
After Placement: Records Cadence and Gap-in-Care Tracking
Placement is the start, not the finish. Set a records rhythm and a gap alarm at the same time.
Records request cadence
Request records and itemized billing every 30 days while the client is treating, and again within a week of discharge. California gives you two useful tools. Evidence Code section 1158 requires a provider to make records available to the patient's attorney within five days of a written authorization, before suit is filed. Health and Safety Code section 123110 governs a patient's own right to inspect and copy records. Once a case is in litigation, records usually move by subpoena; our guide to third-party discovery subpoenas covers that process.
Gap-in-care tracking
Set a calendar rule: if a client misses an appointment or goes 14 days without a visit while under an active treatment plan, the case manager calls the client within one business day. Find out why. Common reasons are pain getting better, a work schedule conflict, transport trouble or frustration with the provider. Document the reason in the client's words. If the client wants to switch providers, help them find options; it is their decision. If they are better and the provider agrees, get a discharge note so the record shows a clean end to care rather than an unexplained stop.
Report gaps to the attorney weekly. A short list of client name, last visit date and reason is enough.
Using a City-and-Specialty Directory to Shortlist Fast
The slowest part of a 48-hour placement is usually the provider search: calling offices that stopped taking liens, or that do not cover the specialty you need in the client's part of town. A directory of providers who accept liens and LOPs, sorted by city and specialty, cuts that step down to minutes.
Use it this way: filter by the client's city and the specialty from your intake notes, pull three to five candidates, and then run the provider call checklist above to confirm current lien acceptance and availability. Present the confirmed options to the client and let them choose. Re-verify any listing before each placement, since a directory tells you where to start, not what a provider will agree to this week.
The 48-hour window rewards offices that treat placement as a repeatable process rather than a favor someone squeezes in between calls. Build the checklist once, run it every time, and the medical record will start telling the client's story from the first week instead of the fifth.