IN THE

SUPREME COURT OF THE STATE OF ARIZONA

PREMIER PHYSICIANS GROUP, PLLC, AN ARIZONA PROFESSIONAL LLC, DBA 

PREMIER PAIN MANAGEMENT, LLC, AN ARIZONA LIMITED LIABILITY 

COMPANY,

Plaintiff/Appellant,

v.

KIMBERLY NAVARRO AND EDDIE NAVARRO,

WIFE AND HUSBAND,

Defendants/Appellees.

No. CV-15-0323-PR

Filed August 30, 2016

Appeal from the Superior Court in Maricopa County

The Honorable Mark F. Aceto, Judge

No. CV2014-090145

AFFIRMED

Opinion of the Court of Appeals, Division One

238 Ariz. 156, 357 P.3d 840 (App. 2015)

VACATED

COUNSEL:

H. Lee Dove, Trevor J. Fish, (argued), Evans, Dove & Nelson, P.L.C., Mesa, 

Attorneys for Premier Physicians Group, PLLC dba Premier Pain 

Management, LLC

Joel DeCiancio (argued), Christopher Robbins, Hill, Hall & DeCiancio, PLC, 

Phoenix, Attorneys for Kimberly and Eddie Navarro

David L. Abney, Dana R. Roberts, Knapp & Roberts, P.C., Scottsdale; and 

Geoffrey M. Trachtenberg, Levenbaum Trachtenberg, PLC, Phoenix, 

Attorneys for Amicus Curiae Arizona Association for Justice/Arizona Trial 

Lawyers Association
PREMIER PHYSICIANS GROUP V. NAVARRO et vir

Opinion of the Court

2

JUSTICE BOLICK authored the opinion of the Court, in which CHIEF

JUSTICE BALES, VICE CHIEF JUSTICE PELANDER, and JUSTICES

BRUTINEL and TIMMER joined.

JUSTICE BOLICK, opinion of the Court:

¶1 We granted review to decide when a non-hospital health care 

provider may perfect a lien to secure its charges. This case turns on the 

statutory requirement that such a lien must be recorded “before or within 

thirty days after the patient has received any services relating to the 

injuries . . . .” A.R.S. § 33-932(A). We hold that the statute requires 

providers to record their liens within thirty days after first providing 

services.

I. 

¶2 Between June and October 2011, Premier Physicians Group 

(“Premier”) treated Mandy Gipson for injuries sustained in a car accident 

allegedly caused by Kimberly Navarro. Health care providers like Premier 

are statutorily entitled to record liens for their “customary charges” in 

treating an injured person; such liens apply to claims the injured person 

may have for damages related to the injury that required treatment. 

A.R.S. § 33-931(A). These liens are perfected by recording pursuant to 

A.R.S. § 33-932. On September 16, 2011, Premier recorded a lien to secure 

payment of approximately $12,000 for its services. In March 2013, the 

Navarros’ insurer paid Gipson directly to settle her claim but did not satisfy 

the lien. Gipson failed to pay Premier for the services it rendered to her.

¶3 In January 2014, Premier sued the Navarros under A.R.S. § 33-

934 to enforce the lien. The Navarros moved to dismiss the action because 

the lien was recorded more than thirty days after Premier first provided 

services to Gipson. Premier argued that § 33-932(A) allowed it to perfect 

the lien within thirty days after services were last provided. Agreeing with 

the Navarros’ statutory interpretation, the trial court dismissed the 

complaint.

¶4 The court of appeals reversed, interpreting § 33-932 as 

allowing health care providers to record liens within thirty days after the 

final service but reaching back only to charges incurred within the thirty 

days before the lien was recorded. Premier Physicians Grp., PLLC v. Navarro, 
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Opinion of the Court

3

238 Ariz. 156, 357 P.3d 840 (App. 2015). The court also granted attorney 

fees to Premier as the prevailing party on appeal under A.R.S. §§ 33-934(B), 

12-341. Id. at 159 ¶ 11, 357 P.3d at 843. The Navarros filed a petition for 

review as to the court of appeals’ statutory interpretation and the attorney 

fees award.

¶5 We granted review because the recording requirement for 

perfecting health care provider liens is a legal question with statewide 

significance. See Blankenbaker v. Jonovich, 205 Ariz. 383, 385 ¶ 7, 71 P.3d 910, 

912 (2003). We have jurisdiction under article 6, section 5(3) of the Arizona 

Constitution and A.R.S. § 12-120.24.

II.

¶6 The Court reviews orders granting a motion to dismiss de 

novo. Coleman v. City of Mesa, 230 Ariz. 352, 355 ¶ 7, 284 P.3d 863, 866 (2012). 

We also review statutory interpretation issues de novo. State v. Hansen, 215 

Ariz. 287, 289 ¶ 6, 160 P.3d 166, 168 (2007).

¶7 The statutes at issue “extend to health care providers a 

remedy not available under the common law—the ability to enforce a lien 

against those liable to the patient for damages in order to secure the 

providers’ customary charges for care and treatment of an injured person.” 

Blankenbaker, 205 Ariz. at 388 ¶ 22, 71 P.3d at 915. Before 1988, such liens 

were available only to hospitals; that year, they were extended to nonhospital health care providers through A.R.S. §§ 33-931, -932. 1988 Ariz. 

Sess. Laws, ch. 298, §§ 2, 3 (2d Reg. Sess.). We refer to those liens collectively 

as “medical liens,” but there are important distinctions between hospital 

and non-hospital health care provider liens that inform our statutory 

interpretation.

¶8 To perfect a medical lien, a health care provider must strictly 

comply with statutory recording requirements. See Nationwide Mut. Ins. Co. 

v. Arizona Health Care Cost Containment Sys., 166 Ariz. 514, 517, 803 P.2d 925, 

928 (App. 1990) (“Although Arizona lien statutes are remedial and are to be 

liberally construed, their provisions must be strictly followed.”). Those 

requirements are set forth in § 33-932(A):
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In order to perfect a lien granted by § 33-931, the executive 

officer, licensed health care provider or agent of a health care 

provider shall record, before or within thirty days after the 

patient has received any services relating to the injuries, 

except a hospital which shall record within thirty days after 

the patient is discharged, in the office of the recorder in the 

county in which the health care provider is located a verified 

statement in writing setting forth all of the following:

1. The name and address of the patient as they appear on 

the records of the health care provider.

2. The name and location of the health care provider.

3. The name and address of the executive officer or agent 

of the health care provider, if any.

4. The dates or range of dates of services received by the 

patient from the health care provider.

5. The amount claimed due for health care.

6. For health care providers other than hospitals or 

ambulance services, to the best of the claimant’s knowledge, 

the names and addresses of all persons, firms or corporations 

and their insurance carriers claimed by the injured person or 

the injured person’s representative to be liable for damages 

arising from the injuries for which the person received health 

care.

¶9 We interpret statutes “to give effect to the legislature’s 

intent.” Parrot v. DaimlerChrysler Corp., 212 Ariz. 255, 257 ¶ 7, 130 P.3d 530, 

532 (2006). A statute’s plain language best indicates legislative intent, and 

when the language is clear, we apply it unless an absurd or unconstitutional 

result would follow. See, e.g., Sell v. Gama, 231 Ariz. 323, 327 ¶ 16, 295 P.3d 

421, 425 (2013). Ambiguity arises when the language is reasonably 

susceptible to differing interpretations. Lewis v. Debord, 238 Ariz. 28, 30-31 

¶ 8, 356 P.3d 314, 316-17 (2015). When a statute is ambiguous, we determine 

its meaning by considering secondary factors, such as the statute’s context, 
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Opinion of the Court

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subject matter, historical background, effects and consequences, and spirit 

and purpose. See Baker v. Univ. Physicians Healthcare, 231 Ariz. 379, 383 ¶ 8, 

296 P.3d 42, 46 (2013). When possible, we seek to harmonize statutory 

provisions and avoid interpretations that result in contradictory provisions. 

See, e.g., State v. Bowsher, 225 Ariz. 586, 589 ¶ 14, 242 P.3d 1055, 1058 (2010).

¶10 The parties both argue that the plain meaning of the words 

“within thirty days after the patient has received any services” in § 33-

932(A) supports their respective readings. But because a patient “has 

received any services” (that is, “some” services) on both the first day of 

services and last, that language in isolation lends itself to two reasonable 

interpretations: the provider must record the lien within thirty days after 

the patient has first received services or it must record the lien within thirty 

days after the patient last received services.

¶11 The court of appeals agreed with the Navarros that reading 

§ 33-932(A) as permitting a non-hospital provider to record a lien within 

thirty days after the provider last provides services eliminates the statutory 

distinction between non-hospital health care providers and hospitals, 

which alone are allowed to perfect liens under § 33-932(A) “within 30 days 

after it has discharged its patient.” Premier, 238 Ariz. at 157-58 ¶ 6, 357 P.3d 

at 841-42. But the court also disagreed with the Navarros’ construction 

because it inserts “an additional requirement into the statute, effectively 

changing it to require a non-hospital health care provider to record a lien 

within 30 days after the patient first receives any services relating to the 

injuries.” Id. at 158 ¶ 7, 357 P.3d at 842.

¶12 Instead, the court interpreted the statute to provide a rolling 

deadline, in which a non-hospital health care provider may record a lien 

within thirty days following any services between the first and last, but only 

for charges incurred within thirty days before the lien was recorded and 

any subsequent charges. Id. at 159 ¶ 9, 357 P.3d at 843. “This construction,” 

the court concluded, “maintains the distinction between hospitals and nonhospital health care providers” and promotes the lien statutes’ purpose to 

“lessen the burden on hospitals and other medical providers imposed by 

non-paying accident cases.” Id. (quoting Blankenbaker, 205 Ariz. at 387 ¶ 19, 

71 P.3d at 914). Under this holding, Premier could recover charges 

beginning thirty days prior to recording the lien but not before then.
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¶13 We find no support in the statutory language for the court of 

appeals’ conclusion that the statute creates such a rolling deadline. Section 

33-932(A) establishes specific triggering events. For hospitals, it is “within 

thirty days after the patient is discharged,” which establishes a time certain. 

For non-hospital health care providers, it is “before or within thirty days 

after the patient has received any services.” Given the clear triggering event 

established for hospitals, it would be anomalous to construe the latter 

language as a rolling rather than fixed deadline without the statute 

expressly saying so.

¶14 Premier suggests the court of appeals appropriately

construed the lien requirements here like the statutory scheme for 

mechanic’s liens, which allows lienholders to recover charges incurred

twenty days before service of the preliminary lien notice and thereafter, but 

not before then. But the mechanic’s lien statutes explicitly allow the 

provider “to claim a lien only for such labor, professional services, 

materials, machinery, fixtures or tools furnished within twenty days prior 

to the service of the notice and at any time thereafter.” A.R.S. § 33-992.01(E). 

In other words, under the mechanic’s lien statute, the triggering event is 

service of the preliminary notice, whereas in the medical lien statute, the 

event is the provision of services (for non-hospital providers) or discharge 

(for hospitals). The different statutory schemes underscore that the medical 

lien statute does not create a rolling deadline for non-hospital health care 

provider liens.

¶15 Because § 33-932(A) encompasses a specific triggering event, 

deciding whether that event occurs at the beginning or end of the provision 

of services does not require us to insert statutory language, as the court of 

appeals suggested, but rather to determine which time the legislature 

intended.

¶16 The meaning of the disputed language in this case is best 

discerned within its broader statutory context. See Robinson v. Shell Oil Co.,

519 U.S. 337, 341 (1997) (“The plainness or ambiguity of statutory language 

is determined by reference to the language itself, the specific context in 

which that language is used, and the broader context of the statute as a 

whole.”); J.D. v. Hegyi, 236 Ariz. 39, 41 ¶ 6, 335 P.3d 1118, 1120 (2014) 

(explaining that when determining a statute’s meaning, words “cannot be 

read in isolation from the context in which they are used”). In construing 
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Opinion of the Court

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statutes, a “cardinal principle” of interpretation is to give effect to every 

clause and word. See Loughrin v. United States, 134 S. Ct. 2384, 2390 (2014). 

For several reasons, viewing the controlling language within the broader 

statutory context supports the Navarros’ proposed construction that the 

lien must be recorded within thirty days after health care services are first 

provided.

¶17 The statute plainly treats hospitals and non-hospital health 

care providers differently in terms of lien recording requirements. After 

stating the non-hospital recording requirement, § 33-932(A) provides, 

“except a hospital which shall record within thirty days after the patient is 

discharged.” If the recording deadline for non-hospital providers meant 

“within thirty days” of the final services provided, it would make the 

exception for hospitals superfluous. State v. Deddens, 112 Ariz. 425, 429, 542 

P.2d 1124, 1128 (1975) (“Statutes are to be given, whenever possible, such 

an effect that no clause, sentence or word is rendered superfluous, void, 

contradictory or insignificant.”). And it would make the requirements for 

hospitals and non-hospital providers essentially the same, with each 

permitted to record a lien within thirty days after final services. By carving 

out the exception for hospitals, the legislature obviously intended different, 

not identical, treatment.

¶18 As to non-hospital health care providers, § 33-932(A) states 

that the lien must be filed “before or within thirty days after the patient has 

received any services.” (emphasis added). When two disjunctive terms 

modify the same action, each possibility must make sense standing alone. 

The phrase “before . . . the patient has received any services,” standing 

alone, is most reasonably understood as meaning before the patient has 

received initial services. If a provider recorded a lien after services began, 

it would not be before the patient has received “any services.” Because 

“before” and “within thirty days after” each modify the same phrase, “the 

patient has received any services,” that phrase is most reasonably 

understood as bearing the same meaning under either modifier, that is, 

when the patient initially receives any services.

¶19 This interpretation is also supported by the statutory 

requirements for the verified statement supporting the lien. In such 

statements, “health care providers other than hospitals . . . to the best of the 

claimant’s knowledge” must provide the names and addresses for any 
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Opinion of the Court

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persons or entities who may be liable for charges covered by the lien. § 33-

932(A)(6). It makes sense to include the proviso “to the best of the 

claimant’s knowledge” only in a non-hospital provider’s verified statement 

because the required information is less likely to be known to the provider 

at the time it records its lien.

¶20 Other parts of the statutory scheme also contemplate and 

support our interpretation. Section 33-932(B) provides that the lien must 

state the amounts due and owing as of the recording date and state whether 

future services will be provided. The lien runs against all amounts incurred 

during this future period. All of the statutory provisions recognize that 

liens will be recorded early in treatment when the provider may not know 

how long treatment may continue or the identities of potential third parties 

responsible for payment. And permitting a lien to run into the future shows 

that the legislature contemplated a lien at the beginning rather than last 

treatment. Because liens are indexed by the patient’s name, there is no need 

to await further information, as Premier argues.

¶21 Our interpretation thus gives meaning to all language in the 

statute and makes sense of the legislature’s different treatment of hospitals 

and non-hospital providers. Health care services provided in connection 

with accidents can be of indefinite duration. Recording a lien within thirty 

days of providing initial services places insurers and other parties on notice 

that any settlements are subject to a lien. At the same time, the non-hospital 

provider will have a lien for charges incurred for the entire service duration. 

Hospitals, by contrast, typically provide services within a discrete and 

identifiable time frame, thus making it sensible to allow them to record a 

lien within thirty days after a patient’s discharge.

¶22 Reading § 33-932(A) to permit non-hospital providers to 

record liens after final services also would undermine claims settlements, 

which our state’s public policy favors. See, e.g., Sturges v. Bennett, 47 Ariz. 

470, 475-76, 56 P.2d 1038, 1040 (1936). Under that reading, the provider’s 

right to record a lien would revive any time a patient returned for services 

relating to a particular accident—even after considerable intervening time.

¶23 Viewing the disputed language in the context of the entire 

statute thus yields only one reasonable interpretation. For these reasons, 

we conclude the legislature intended § 33-932(A) to require non-hospital 
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providers to record liens before services are first provided or within thirty 

days thereafter. Premier’s lien was not timely recorded, and the trial court

therefore properly dismissed Premier’s claim against the Navarros.

III.

¶24 Section 33-934(B) authorizes an award of reasonable attorney 

fees to a “prevailing party” in an action arising under § 33-931. Because

Premier is no longer the prevailing party, we need not decide whether the 

court of appeals correctly awarded Premier fees. We, therefore, reverse the 

court of appeals’ award of attorney fees and costs to Premier.

¶25 The Navarros seek attorney fees and costs for litigation in this 

Court. They are entitled to recover costs pursuant to A.R.S. § 12-342 and 

we exercise our discretion to award them reasonable fees as the prevailing 

parties under § 33-934(B).

IV.

¶26 We vacate the opinion of the court of appeals and affirm the 

trial court’s dismissal of Premier’s complaint. We award reasonable 

attorney fees and costs incurred in this Court to the Navarros upon 

compliance with ARCAP 21(b).