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Berkeley S. Capelo

Berkeley Capelo joined Gjerset & Lorenz, LLP as a reimbursement and finance analyst in 2019. In this role, Ms. Capelo focuses on assisting attorneys through the provision of analytical support related to providers’ participation in governmental reimbursement programs including the Medicaid Disproportionate Share Hospital program, Uncompensated Care Cost program, the Texas Delivery System Reform Incentive Pool program, and related application and audit activities. Working with data and financial reports from client provider and governmental sources, Ms. Capelo extrapolates vital information through strategic analyses to assist clients with establishing eligibility to participate in and maintain compliance with various government reimbursement programs. In addition, Ms. Capelo analyzes collaborations between multiple hospital systems to support local initiatives that strategically address healthcare need. Ms. Capelo has also assisted in analysis related to the preparation of health care service agreements for the acquisition of a major teaching hospital system, and in the development of healthcare reform initiatives to assist in the establishment of a value-based purchasing program. Ms. Capelo has brought her driven problem-solving skills with a strong understanding of financial and security industry practices to Gjerset & Lorenz, LLP. She is an adaptable and solutions-focused finance professional who is quick to learn and apply new processes, technologies and information in order to keep pace with the rapidly evolving and growing industry of healthcare.

Ms. Capelo:

  • Assists hospitals to determine amounts to report related to participation in Medicaid disproportionate state hospital (DSH) and other supplemental payment programs, including reporting of uninsured costs, state and local government program revenue, charity care and Medicaid utilization.
  • Performs analysis of and assists with reporting of uninsured costs, state and local government program revenue, charity care and out-of-state Medicaid utilization for qualification and participation in Medicaid reimbursement programs.
  • Analyzes the impact of operational changes on Medicaid reimbursement.
  • Performs strategic analysis of patient-level data to extrapolate information necessary for self-reporting.
  • Analyzes hospital cost reports to advise clients on costs eligible to include in uncompensated care reporting.
  • Assists providers in forecasting revenues based on analysis of applicable reimbursement caps and the rules governing providers’ entitlement.
  • Analyzes statewide Medicaid claims data to assess the reimbursement impact of changes in Medicaid utilization.
  • Analyzes the impact on reimbursement from the consolidation or deconsolidation of hospitals.
  • Facilitates coordination with hospitals and governmental entities applicable to their participation in reimbursement programs supported by intergovernmental transfers (IGTs).

Education

  • Securities Industry Essentials (SIE) Exam, FINRA, 2019
  • Bloomberg Certified, Bloomberg Market Concepts, 2019
  • Certified Health, Life, and General Lines Insurance, Texas Licensed, 2017
  • Southern Methodist University, Dedman College of Humanities and Science, Bachelor of Science in Economics with Finance Applications, Minor in Environmental Earth Sciences with Petroleum Geology Applications, 2017