Carrie Douglas is a passionate advocate who works tirelessly to achieve maximum reimbursements from commercial payors and third-party administrators for hospital systems, ambulatory surgery centers and large physician practices. She represents clients in a variety of reimbursement related legal disputes, involving managed care contracts and other payor-provider disputes wherein she uses her efforts to resolve matters at the pre-litigation stage.
Carrie has extensive experience on matters pertaining to unilateral payor policies involving COVID-19 reimbursement, reference-based pricing, out-of-network plans and E/M downcoding. She has also established successful strategies related to disputes involving experimental/investigational designations, medical necessity, diagnosis-related groups (DRG) downgrades and refunds, offsets and other adjustments, which have allowed for pre-litigation resolutions. In addition, she advises hospitals and health systems on compliance with the Hospital Price Transparency Rule.
Dedicated to her clients’ business success, Carrie has brought in more than $16 million over the past six years for West Texas’ largest regional health system.
