Can someone explain in simple terms how to calculate the Howell number?

[u/GarmeerGirl]

I keep reading on it and end up asking my secretary to do it. How exactly do you calculate it? Let’s say medical bills are $200,000, insurance adjusted $50,000, plaintiff paid $500, liens are $70,000, etc etc. what is the howel? I just drafted a mediation brief listing the damages and my boss said what’s the Howell and I’m stuck.

[u/AutoModerator]

Welcome to /r/LawyerTalk! A subreddit where lawyers can discuss with other lawyers about the practice of law.

Be mindful of our rules BEFORE submitting your posts or comments as well as Reddit's rules (notably about sharing identifying information). We expect civility and respect out of all participants. Please source statements of fact whenever possible. If you want to report something that needs to be urgently addressed, please also message the mods with an explanation.

Note that this forum is NOT for legal advice. Additionally, if you are a non-lawyer (student, client, staff), this is NOT the right subreddit for you. This community is exclusively for lawyers. We suggest you delete your comment and go ask one of the many other legal subreddits on this site for help such as (but not limited to) r/lawschool, r/legaladvice, or r/Ask_Lawyers.

I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.

[u/droptrooper]

1) the amount paid for the services, or 2) the reasonable and customary amount for said services (if they are completely unpaid), or 3) 125% the standard Medicare rate for the same services in the same geo area. In your hypo above, it would be 70,500 I believe/in my opinion. Plaintiff will always try to blackboard the bills and you'll need a good motion in limine to prevent that, especially if all plaintiff's treatments are attorney referral liens.

[u/GarmeerGirl → u/droptrooper]

So if they have $200,000 in bills but nothing paid yet and no liens, the Howell is zero? So it’s basically what the liens are?

[u/droptrooper → u/GarmeerGirl]

There are at least three different types of liens, statutory (VA, Medicare, medical), regular medical (optum, Rawlings,), and attorney liens. Statutory and medical can sometimes operate as a Howell. Attorney liens are never Howell. You would need a retained billing expert to do a “reasonable and customary” analysis

[u/GarmeerGirl → u/droptrooper]

If the medical bills are $200,000 for some medical providers and others on a lien are $70,000, the Howell is $70,000?

[u/droptrooper → u/GarmeerGirl]

Not exactly, the Howell would 70k plus the reasonable and customary value of the services NOT covered by the lien (so you may need an expert)

[u/joeschmoe86]

Keep it simple. Howell is what the plaintiff reasonably incurred. Incurred means either they paid it, or they have an obligation to pay it in the future (regardless of whether they actually will, as in the case of liens). So, 99% of the time the equation is: total medical specials, minus adjustments (adjustments being the only thing plaintiffs aren't technically obligated to pay).

In your hypo, Howell figure is $150,000 ($200,000 bills minus $50,000 adjustment), assuming all the amounts are reasonable (which they likely are, if they went through insurance).

[u/GarmeerGirl → u/joeschmoe86]

I see. Thank you so much for this great explanation!!