An experienced healthcare partner

Carrie Douglas is a passionate advocate for healthcare providers. Carrie works tirelessly to achieve maximum reimbursements from commercial payors and third party administrators for hospital systems, ambulatory surgery centers and large physician practices. She develops cost-effective pre-litigation solutions for her clients’ reimbursement issues, and she navigates the tricky balance of expediting resolutions of these disputes with the impact of the settlements on future dealings with payors.

Primarily representing in-network providers, Carrie has built an impressive track record resolving coverage and reimbursement disputes between healthcare organizations and private health insurers and public payors. Her experience includes issues related 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, DRG downgrades and refunds, offsets, and other adjustments, which have allowed for pre-litigation resolutions. Additionally, Carrie is advising hospitals and health systems on compliance with the newly enacted Hospital Price Transparency Rule.

Carrie grew up with parents who were in the healthcare field, and her husband is an electrophysiologist as well. She routinely draws from that background when assisting her clients. She deeply understands the revenue cycle needs of providers, and she is dedicated to her clients’ success. Carrie has brought in an excess of $13 million dollars over the past 5 years for the largest regional health system in West Texas.

Carrie is active in the medical community where she speaks regularly to residents and fellows on how to negotiate physician employment contracts and the best strategies to use to maximize reimbursement.

Prior to joining Waller, Carrie was a member of Clark Hill, where she successfully resolved overpayment and recoupment demands in the favor of providers and negotiated several million dollars in favorable settlements for healthcare clients involving under-reimbursement of insurance claims by national health insurance companies.