Beverly is an industry-leading expert in managed care compliance auditing, performing health plan operational assessments; encounter data accuracy and other managed care program compliance engagements; fraud and abuse detection; and developing audit strategies across all health plan and provider types. She also serves as a subject matter expert for engagement-related health care data privacy and security concerns. Beverly serves as the firm’s Privacy Officer.
Beverly’s three decades of broad experience include, among other things, analysis of financial and utilization data, analyses of the health plan business models, fact finding interviews, on-site procedures, and contract analyses. She is a leader in the firm’s Medicaid managed care practice area where her responsibilities include consulting on monitoring and reporting of health plan compliance with contractual and regulatory provisions, encounter data completeness and accuracy assessments, external quality reviews, on-site financial audits, and other reconciliations. She also provides technical expertise on various program integrity engagements including post-payment review of claims and fraud, waste, and abuse detection. She communicates with and serves as a liaison to providers and professional associations, oversees the preparation of written and oral reports, and regularly presents to the state agencies and stakeholders.
Beverly is a Certified Public Accountant (CPA), Certified in Financial Forensics (CFF), a Certified Fraud Examiner (CFE), Certified in Healthcare Privacy and Security (CHPS), and is Certified in Healthcare Privacy Compliance (CHPC). She is a member of the American Institute of Certified Public Accountants, the Association of Certified Fraud Examiners, the Indiana CPA Society, the Kentucky Society of Certified Public Accountants, the Georgia Society of Certified Public Accountants, the Healthcare Financial Management Association, the Healthcare Compliance Association, and the American Health Information Management Association.
Education
B.S., Accounting
Indiana University
Specialties
- Analysis of managed care health plan internal controls, financial and encounter data completeness and accuracy, and external quality review.
- Health plan contract and regulatory compliance.
- Managed care program consulting.
- Program integrity efforts, post-payment claims examinations, certified in financial forensics.
- Health care data privacy and security.
- Rate setting, policy development, and regulations.
“The institutional knowledge at Myers and Stauffer spans many decades and across the entire country. We know where health care has been and where it is going, and we can share that knowledge with our clients so their programs are more efficient, more effective, and more innovative.”
— Beverly Gehrich