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A lien is just a claim by a creditor. It's designed to give a creditor a chance to file a lawsuit to adjudicate a claim.

Depends on what kind of lien. Mechanic's liens (generally for work on a property) can often be filed by just recording them, depending on your state's laws. Most liens from other creditors, such as medical bills (which was the subject of the question), credit cards or taxes, need to have a judgment found against the property owner first. Getting a judgment generally requires a lawsuit to be filed and adjudicated in the creditor's favor prior to the creditor being able to place the lien. (Again - depending on your state's laws.)

It typically prevents a property from being sold until that claim has been resolved by a court.

Liens don't necessarily prevent the property from be sold, as long as the lien can be satisfied as a part of the sale of the property. If the seller is underwater, so that the lien can't be satisfied, then there can be issues with selling the property.

If a creditor has a mortgage on a property and is foreclosing on the property, BK will typically prevent that foreclosure from proceeding until the bankruptcy has been resolved, or at least until the BK court gives permission for foreclosure to proceed.

Correct, but that wasn't the question that was asked.

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