the underlying patient account, i.e. the debt. As such, we simply hold that, according to the pleadings here, Ms. Morgan’s debt has been extinguished. A lien cannot exist in the absence of a debt, and thus Ms. Morgan’s pleadings have stated a cause of action so as to survive a motion for judgment on the pleadings. Therefore, the case is remanded for further proceedings as the trial court deems appropriate in light of this opinion. All concur. 1 . All statutory references herein are to RSMo Cum.Supp.2011 unless otherwise noted. 2 . The parties and the court refer variously to section 430.230 and section 430.235; however, for the purposes of this opinion, the relevant language of each section is the same. 3 . See Dorr v. Sacred Heart Hosp., 228 Wis.2d 425, 597 N.W.2d 462, 467 (App.1999) (<HOLDING>); Midwest Neurosurgery, P.C. v. State Farm Ins.
holding that because the trial court did not abuse its discretion in finding the expert report adequate as to the vicarious liability claim against the hospital based on the actions of the doctors plaintiffs suit against the hospital including her claim that the hospital was vicariously hable for the actions of its nurses could proceed holding that because the contract between the hospital and the health insurance company had a hold harmless provision which stated the hospital would not bill or hold insurance subscribers liable for any hospital expenses covered by the subscribers insurance contract and all expenses from the patients treatment for the automobile accident were covered in such contract there was no debt upon which the hospital could assert a lien pursuant to the states hospital lien statute holding that where hospital used balance billing its lien was unenforceable because the hospital had been paid in full for the services it provided to patient and there was consequently no debt to secure by the existence of the lien holding that physicians as agents of the hospital are indistinguishable from the hospital for immunity purposes under the lgaa holding that where hospital used balance billing that since the hospital had already received payments from the patient and his health insurer and had agreed to accept that amount as payment in full for its services there was no longer any amount owing to the hospital and thus it could not assert a statutory hospital lien for the difference between its charges and the amount received in light of the negotiated network agreements