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8/8/2019 MGMA State Leadership Conference 2011 - Denver II
1/13
MEDICAL GROUP MANAGEMENT ASSOCIATI
Two days in Denvercan make all the differenceIn your leadership.In your membership.
MGMA 2011 StateLeaders Conference
FEb. 11--12, 2011 DENvER
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Many thanks to our conference sponsorYoure here for answers, and youve come to the right place.
Who should attend
The target audience for this conference is officersand paid staff for MGMA state affiliates. Officers,
chairs and paid staff may participate in the sessionthat will be most helpful to them and their stateassociations. MGMA also welcomes members whoare not currently involved in state leadership butare interested in pursuing such service. Presidentsof state associations who have identified futureleaders within your association are encouraged toattend.
Why you should attend
Whether you are a current State MGMA officer,
chair, staff contact, or aspiring state leader, theMGMA 2011 State Leaders Conference offersthe education and inspiration you need to be asuccessful leader.
Learn from your peers Share experiences,get practical tools and gain information.Whatever issues your organization faces fromvendor relationship building to leadershipdevelopment youll return from the MGMA 2011State Leaders Conference with the knowledge andskills to tackle the challenge.
Network with your peers Get hands-on advice andpractical solutions that only your colleagues inother state MGMAs can provide. Youll have plentyof opportunities to catch up with old friends and
connect with new ones.
Conference site
Set against the stunning backdrop of the RockyMountains, the Renaissance Denver Hotel isconveniently located midway between DenverInternational Airport and downtown Denver.
Centered in the Stapleton redevelopment area, thelargest urban redevelopment project in the world,the hotel is near many attractions. The crown
jewels of the Stapleton area are the new Shops atNorthfield and Dicks Sporting Goods Park, homeof the Colorado Rapids Major League soccer team.
Join us in the Mile High City!
General Information
Lanyard sponsor
Let us make you aware of anarray of products and servicesto meet your needs.Spend your networking breaks atthe exhibitor tables, where youllfind solutions and build importantrelationships.
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Schedule at a Glance
Thursday, Fe . 10Noon-3:00 pm Conference registration open
3:00 pm Shuttles depart hotel
4:00-6:00 pm Welcoming Reception atMGMA Headquarters
6:00 pm Shuttles depart MGMAHeadquarters
Friday, Fe . 11
6:00-8:00 am Breakfast in hotel restaurant(included in room rate)
7:00 am-5:00 pm Conference registration open
7:30-8:55 am MGMA Joint Council of Section Officers Meeting(invite only)
7:30-8:55 am State Staff Meeting
9:00 am-noon Individual Section Councilof State Leaders (COSL)Meetings
Noon-1:00 pm Keynote sessionMGMA/ACMPE Update
1:00-2:00 pm Concurrent sessions100 series
2:00-2:30 pm Networking break
2:30-3:00 pm Speaker Showcase sessionImpact of Individuals on
Lobbying Efforts
3:00-3:30 pm Speaker Showcase sessionAre You Surviving orThriving?
3:30-4:00 pm Networking break
4:00-5:00 pm Concurrent sessions200 Series
Saturday, Fe . 126:00-8:00 am Breakfast in hotel restaurant
(included in room rate)
7:00 am-3:45 pm Conference registration open
8:00-9:15 am General sessionWashington Update
9:15-9:45 am Networking break
9:45-10:45 am Concurrent sessions300 Series
10:45-11:15 am Networking break
11:15 am-12:30 pm Concurrent session400 Series
12:30-1:30 pm Networking luncheon
1:30-2:00 pm Speaker Showcase session$tart a new discussion
2:00-2:30 pm Speaker Showcase sessionStrengths-Based Leadership:Leveraging Talent forOrganizational Outcomes
2:30-3:15 pm Networking break
3:15-4:15 pm Hot Topic Round Tables
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9:00 am-noon
Individual MGMA Section Council of StateLeaders (COSL) meetingEach section meets individually with its stateleaders and staff. All participants (state andnational) attend their respective section meeting.
Noon-1:00 pm
Keynote session: MGMA/ACMPE Update(lunch will be served)
Organizational Governance
William F. Jessee, MD, FACMPE, president and chief executiveofficer, Medical Group Management Association, Englewood,Colo.; Shena Scott, MBA, FACMPE, executive director, Brevard Anesthesia Services PA and chair, MGMA Board of Directors;and Alan D. Winkler, MHSA, FACMPE, vice president of clinic operations, St. Vincent Health System, Little Rock, Ark. and chair, ACMPE Board of Directors
Get an update on association business trends fromthe MGMA president and the newly elected boardchairs. During this presentation, you will discoverthe trends, challenges and opportunities affectingAssociations in the coming year.
Conference Schedule
Thursday, Fe . 104:00-6:00 pm
Welcoming Reception at MGMAHeadquarters
Join your colleagues at the MGMA Headquartersfor drinks and hors doeuvres.
Friday, Fe . 116:00-8:00 am
Breakfast in hotel restaurant(included in room rate)
7:00 am-5:00 pmConference registration open
7:30-8:55 am
Joint Council of Section Officers Meeting(invite only)MGMA national section officers will meet anddiscuss topics of concern and interest.
7:30-8:55 am
MGMA State Staff MeetingThis session is always valued whether you area new or seasoned state staff contact. Join yourfellow state staffers to discuss issues unique to yourrole.
Nancy Enos, FACMPE, CPC-I, CEMC, consultant, Nancy EnosMedical Consulting, Warwick, R.I., MGMA Eastern SectionChair
Rosemarie Kuntz , MBA, FACMPE, clinical departmentmanager, Mid Dakota Clinic, PC, Bismarck, ND, MGMAMidwest Section Chair
Jean Hansen , MBA, FACMPE, chief executive officer,Gastroenterology Consultants, Independence, MO, MGMASouthern Section Chair
Judy Montgomery , CPA, MBA, FACMPE, practiceadministrator, Cardiovascular Surgery of Southern Nevada,Las Vegas, NV, MGMA Western Section Chair
Mindy Zau i, executive director, Illinois MGMA, OhioMGMA and South Florida MGMA, Woodstock, Ga.
Nancy A. Martin, MBA, CMPE, administrator, CantonAultman Emergency Physicians, Canton, Ohio, MGMAMidwest Section Board Representative
Many thanks to the planning committee for the MGMA 2011 State Leaders Conference:
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1:00-2:00 pm
Concurrent sessions 100 series101. Membership Recruitment and RetentionBusiness Operations
Dana Guilfoyle, vice president, Communications and Marketing,Medical Group Management Association, Englewood, Colo.,Mindy Zaubi, executive director, Illinois MGMA, Ohio MGMA andSouth Florida MGMA, Woodstock, Ga., and Melissa O. Wilson,executive director, Tennessee MGMA and Kentucky MGMA,Brentwood, Tenn.
Everyone knows it is more expensive to attracta new customer than to keep an existing one.As association professionals, our lifeline is ourmembership base. The explosion of digital mediaand business intelligence software provides the
opportunity to deliver relevant communications atprime touch points in the membership cycle.
This session will provide you with the knowledge to:
Discuss best practices for retention marketing
Discover how the national MGMA has revampedits marketing efforts via digital marketing
Examine different methods and testing processes,and leave armed with tips and tricks toimplement at your association
102. Key Insights from a Legislative AideRisk Management
Speaker TBD
Legislative aides provide support and access toelected officials. Learn first-hand from a legislativeaide how to get time with your legislator, the bestway to present to your legislators and how to besuccessful in your grassroots efforts.
This session will provide you with the knowledge to:
Describe how legislative aides can benefit ingrassroots efforts
Discuss the best ways to contact your legislators
103. All Chiefs, No Indians: LeadingVolunteer LeadersGeneral Competencies: Leadership Development
Deb Wiggs, FACMPE, chief executive officer, Trinity Management
Solutions, Bellingham, Wash.
Maintaining effective leadership in a professionalorganization of leaders can either hone or dullyour own leadership skills. What are some of the critical requirements needed to support yourleadership efforts and provide your associationwith both consistent and persistent leadership?This session will give you some ideas andcomponents that provide a framework for effectivemanagement and leadership in a volunteerorganization, such as planning and accountability.
This session will provide you with the knowledge to:
Describe how to use a strategic plan for structure
Discover the communication and character traitsof leaders
Identify how to handle difficult situations
104. State ACMPE Forum RepresentativesRound TableStrengthen your relationship with your MGMAstate association, promote ACMPE effectively andserve your state members by coming prepared toshare ideas with other Forum Representatives.
This session will provide you with the knowledge to:
List three ways to promote ACMPE and serveyour state members
2:00-2:30 pm
Networking break
Conference Schedule
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2:30-3:00 pm
Speaker Showcase session: Impactof Individuals on Lobbying Efforts
Risk Management Joel Blackwell, speaker and author, Washington, D.C.
Communication with elected officials is the keyto lobbying efforts. During this session, you willlearn how individuals can impact public policy bycommunicating with elected officials, which kindsof communications work best, why relationshipsmatter and how to deal with the competition forattention caused by the deluge of informationpouring into their offices.
This session will provide you with the knowledge to: Describe which kind of communication works
best in lobbying efforts
3:00-3:30 pm
Speaker Showcase session: Are YouSurviving or Thriving?Financial Management
James A. Stroud, CPA, member, Warren, Averett, Kimbrough andMarino LLC, Birmingham, Ala.
There are forces in our culture that press on us tothe point of reducing us to a survival mentality.This session will bring the problem into focus andillustrate that the solution to living a positive,impactful and enthusiastic life lies within each of us.
3:30-4:00 pm
Networking break
4:00-5:00 pm
Concurrent sessions 200 Series201. Association Finances Inquiring MindsWant to KnowFinancial Management
James A. Stroud, CPA, member, Warren, Averett, Kimbrough andMarino LLC, Birmingham, Ala.
Accounting processes for an association mustsatisfy governmental reporting requirements, butthe same processes must exceed the expectations
of your officers, board and members. And all mustbe accomplished without an improper use of fundshappening on your watch. This session will enableyou to identify the external and internal interestedparties, and understand the distinction betweenfinancial data and useful association managementfinancial information.
This session will provide you with the knowledge to:
Recognize how time invested in the chart of accounts will provide better information forassociation management
Learn how to connect financial reporting formatswith association goals
Describe how to lessen the likelihood thata fraud or impropriety occurs under yourleadership
Conference Schedule
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202. Your Associations Role in GrassrootsEffortsRisk Management
Joel Blackwell, speaker and author, Washington, D.C.
Your organization can have a large impact onpublic policy. During this session, the speaker willreview best models and practices for maximizingthe impact of your organization on public policy.To have the most impact, your association willneed to create a key contact network that willrecruit, motivate, educate and activate yourmembers to communicate with elected officeholders.
This session will provide you with the knowledge to:
Describe the importance of reward andrecognition, the role of leadership of boardand officers, and why members are reluctant toengage in political communication and how toovercome that reluctance
203. Deepening Your Volunteer PoolLeadership Development
Betsy Holt, MSS, director of member engagement, Medical GroupManagement Association, Englewood, Colo.; Bonnie Grevengoed,practice administrator, The Fertility Center, Grand Rapids,Mich.; and Karen Larossi, CMPE, manager, Hand-Elbow-Shoulder
Surgical Specialists of Alaska, Anchorage
Are you tired of recycling the same set of volunteers year after year? Sure, they do a goodjob, but getting some new blood and new ideaswould be good, too. How do you expand yourvolunteer pool? In this interactive session, welltake a look at some key findings from volunteerresearch that can help us understand how to makeit easier for your members to volunteer. Wellshare some best practices and success stories fromMGMAs national and state offices.
This session will provide you with the knowledge to:
List three key ideas that will help you grow yourvolunteer pool
Describe three barriers that prevent potentialvolunteers from stepping up
204. State Staff Round Table*Information Management
Mindy Zaubi, executive director, Illinois MGMA, Ohio MGMA andSouth Florida MGMA, Woodstock, Ga.
During this interactive discussion, state staff willdiscuss some of the common issues facing MGMAstate associations as well as share ideas and bestpractices.
This session will provide you with the knowledge to:
Identify new opportunities for implementationfor your state association
*State staff only.
205. Overview of ACMPE Certification:Taking the Trip from Nominee to CertifiedMember to Fellow*Beth A. Balen, FACMPE, Western Section Forum Coordinator, ACMPE, and Maria F. Petro, FACMPE, Eastern Section ForumCoordinator, ACMPE
Participating in the American College of MedicalPractice Executives (ACMPE), MGMAs standard-setting and certification body, is the best way todemonstrate your leadership and competencein medical practice management. ACMPE offers
nationally recognized board certification andFellowship programs. Gain an understanding of the process and requirements necessary to attainACMPE board certification and Fellowship, as wellas the resources and programs to get you there.Identify ways that ACMPE certification can furtheryour professional development and personalgrowth.
This session will provide you with the knowledge to:
Identify ways that ACMPE board certificationand Fellowship can further your professionaldevelopment and personal growth
* ACMPE Forum representatives received waived registration fees for the conference, and a $250 travelstipend to encourage attendance.
Conference Schedule
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Saturday, Fe . 126:00-8:00 am
Breakfast in hotel restaurant(included in room rate)
7:00-4:15 pm
Conference registration open
8:00-9:15 am
General session: WashingtonUpdateRisk Management
Allison Brown, government affairs representative of MedicalGroup Management Association, Washington, D.C.
Medical practices often receive late andcontradictory information on the actions of Capitol Hill and the administration affectinghealth care and daily administrative burdens.Provided in this update will be timely informationon the regulatory and legislative issues underconsideration by the administration and theCongress. Highlights contain MGMAs advocacyobjectives for 2011 and the important grassroots
role that members must play in achievingadvocacy success.
This session will provide you with the knowledge to:
Discuss proposed regulatory and legislativechanges affecting medical groups
Identify recent changes in Medicarereimbursement and program policies
Recognize the challenges practices will faceimplementing and complying with newregulations
List ways you can effectively participate inadvocacy efforts
9:15-9:45 am
Networking break
9:45-10:45 am
Concurrent sessions 300 Series302. Strategic Planning from the Ground UpOrganizational Governance
Kenneth T. Hertz, FACMPE, principal consultant, Medical GroupManagement Association, Englewood, Colo.
The saying goes, If you dont know where youregoing, theres a good chance you wont get there.In order for organizations to achieve their goals,they must have a mission, vision and values
supported by a thoughtful and sound strategicplan. Working from the group up, this sessionwill cover the foundational aspects of strategicplanning vision, mission and values thenaddress the process and approach for developingthe strategic plan.
At this session, participants will:
Discuss the importance of mission, vision andvalues, and how to ensure their relevance today
Discover how to identify and include keystakeholders in the strategic planning process
Explain how to orchestrate the process fordevelopment of a strategic plan
Recognize how to develop a strategic plan fortheir organization
Conference Schedule
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303. Getting Leaders from YourVolunteer PoolOrganizational Governance
Nancy M. Enos, FACMPE, CPC-I, CEMC consultant, Nancy Enos
Medical Consulting, Warwick, R.I.
Succession planning is an important responsibilityof state officers. State leaders often struggle withthe selection of the best candidates for futureboard positions. This session will discuss ways toidentify the best possible candidates for leadershipin your volunteer pool. Leaders must recognizeand avoid pitfalls of volunteers who say yeswhen invited to fill a roll, only to disappear or fallshort of meeting the responsibilities of the role.
This session will provide you with the knowledge to: Discuss strategies to give current and future
state leaders a plan to identify, enlist, evaluateand mentor the right people to ensure positiveleadership in the future of the state association
304. State Staff session*Business Operations
Mindy Zaubi, executive director, Illinois MGMA, Ohio MGMA andSouth Florida MGMA, Woodstock, Ga.
During this interactive roundtable discussion, state
volunteers will share best practices for leadingtheir association into the future and on providingservices to their membership.
This session will provide you with the knowledge to:
Identify new opportunities for implementationfor your state association
*State staff only
10:45-11:15 am
Networking break
11:15 am-12:30 pm
Concurrent session 400 Series401. Effective Lobbying at the State LevelRisk Management
Lawrence Epstein, MPA, CMPE, chief executive officer, Pulmonary Allergy Associates, PA, Highstown, NJ, Diane Bristol, administrator,Midland Ob-Gyn Associates, PC , Midland, Mich., Stewart Clark,PhD, practice administrator, Cardiology Center, LLC,Marrero, La., and Janet McIntyre, MBA, FACMPE, consultant, J E MHealthcare Consultants, Denver
Your state association can have a big legislative
impact at the local level. There are many ways torally the troops, and make significant headway,during this session, you will hear several options.The panelists will also discuss the governancestructure at their state association that supportsadvocacy efforts.
This session will provide you with the knowledge to:
Describe various activities that the stateassociation can implement to advance legislativeissues
Discuss different types of governance structuresthat support advocacy at the local
Conference Schedule
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402. From Plan to Action: Youve Got YourPlan, Now What?Organizational Governance
Kenneth T. Hertz, FACMPE, principal consultant, MGMA,
Englewood, Colo.
The payoff for strategic planning is theachievement of strategic goals and objectives.Many organizations complete the planningprocess successfully but fail to achieve thedesired results. This session presents tools andtechniques that leaders can use to ensure successin the deployment of their strategic plan. Thepresentation will be didactic in nature, withspecific examples provided that demonstrate bothsuccess and failure.
This session will provide you with the knowledge to:
Discuss how to apply the tools and techniquespresented to ensure success in their organizations
Recognize the importance of SMART goals,individual accountability and the importance of hardwiring processes to ensure success
Review the importance of evaluation in strategicplanning along with the concept of a loopedprocess
403. Managing VolunteersLeadership Development
Betsy Holt, MSS, director of member engagement, Medical GroupManagement Association, Englewood, Colo.
Volunteers can extend the human capital of yourorganization. Furthermore, volunteers who have agood experience will be more satisfied and possessgreater loyalty to your group. How can you createa system to manage volunteers that effectivelyuses their skills and time, while ensuring agood time had by all? In this session, we willdiscuss key elements of different approaches tovolunteer management and describe the volunteermanagement program being built at MGMAnational.
This session will provide you with the knowledge to:
Describe important attributes of a volunteermanagement program
Conference Schedule
404. How to use your ACMPE State ForumRepresentative to Enhance your MembersExperienceVenus K. Biskus, FACMPE, Midwest Section Forum Coordinator,
ACMPE, and Susan Childs, FACMPE, ACMPE Forum Representative,North Carolina
What is the benefit of promoting professionalcertification to your state members? Participationin the American College of Medical PracticeExecutives (ACMPE), MGMAs standard-setting andcertification body, is the best way to demonstrateleadership and competence in medical practicemanagement. This session is designed for stateleaders to learn how to best utilize your ACMPEstate forum representatives to provide your state
members the opportunity to pursue certificationand Fellowship in ACMPE. Following this session,you will be able to use ideas from other stateassociations to encourage your members to pursuethe benefits of ACMPE board certification andFellowship. Current state Forum representativesare also encouraged to attend to share successfulactivities.
This session will provide you with the knowledge to:
Incorporate ideas from other state associations toencourage your members to pursue the benefitsof ACMPE board certification and Fellowship
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12:30-1:30 pm
Networking luncheon
1:30-2:00 pm
Speaker Showcase session:$tart a new discussionFinancial Management
Todd Evenson, MBA, assistant director of survey operations,Medical Group Management Association, Englewood, Colo.
Health reform, physician shortages andgenerational differences impact physiciancompensation. Ultimately, these factors affect theway you recruit and retain physicians. In order tomeet tomorrows challenges, you will need to bekeenly aware of the evolving market conditionsthat will transform the way you engage physicians.So what really matters?
This session will provide you with the knowledge to:
Identify market conditions that will change theway you recruit
Understand generational differences that impactwhat each physician values
Explore tomorrows compensation and benefitspackages
2:00-2:30 pm
Speaker Showcase session:Strengths-Based Leadership:Leveraging Talent forOrganizational OutcomesGeneral Competencies: Leadership
Laurie K. Baedke, FACHE, CMPE, president, The LIFEworks Group,Omaha, Neb.
How can leaders tap in to the true potential of their organizations greatest asset, their employees?Today, a companys market value depends less onits tangible assets and more on its human capital.Great leaders and great organizations must notonly accommodate the fact that each employee isdifferent, they must capitalize on those differences.They must watch for clues to each employeesnatural talents and then position and develop eachemployee so that his or her talents are transformedinto bona fide strengths. By changing the way
healthcare organizations select, measure, developand channel the careers of their people, they canbuild an entire culture around the strengths of each individual.
This session will provide you with the knowledge to:
Describe how physician groups and healthcareorganizations have driven growth by focusing onthe talent of their employees and departments
Discover strategies to create, implement andsustain a high-performance culture
Discuss how to teach all employees to identify,deploy and develop their strengths
2:30-3:15 pm
Networking break
3:15-4:15 pm
Hot Topic Round TablesBusiness Operations
During this interactive round table discussion,state volunteers will share best practices for leadingtheir association into the future and on providingservices to their membership.
This session will provide you with the knowledge to:
Identify new opportunities for implementationfor your state association
Round Table topics include governance, productsand services, communication and programplanning
Conference Schedule
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HotelRenaissance Denver Hotel3801 Quebec Street, Denver, CO 80201Phone: 1.888.238.6762
Special conference room rate:$109.00/night plus 14.85% tax per night
A block of rooms is reserved especially for youat The Renaissance Denver Hotel at the reducedrate. Call the hotel directly for sleeping-roomreservations and ask for the MGMA 2011 StateLeaders Conference block and rate. Discountedrooms are available until Monday, Jan. 24, 2011or until they sell out. After this date, reservationsat the conference rate will be accepted on a space-available basis only.
A first nights deposit, by check, cash or creditcard, including tax, must accompany allreservation requests
Hotel transportationComplimentary transportation is available to andfrom Denver International Airport. Pick up at theairport is on baggage claim Level 5 on the westside of the terminal, between doors 506 and 508,or on the east side, between doors 509 and 511.Shuttles run every 30 minutes. Be sure to scheduleyour shuttle time back to the airport at the hotel
in advance, not that morning, as space is limited.Reimbursement for State LeadersConferenceMGMA will waive the registration fee to theState Leaders Conference for one (1) state boardmember, one (1) state staff (non-transferable)and for one (1) ACMPE Forum representative(non-transferable) to attend the conference. Inaddition, MGMA will also provide each state areimbursement of up to $250 for a state boardmember and the ACMPE Forum representative.In addition, MGMA will provide each state areimbursement of up to $250 for a state boardmember and ACMPE will provide each state areimbursement of up to $250 for a State ForumRepresentative.
Cancellation policyAll registration cancellations must be receivedin writing to the MGMA Service Center, 104Inverness Terrace East, Englewood, CO 80112, orfaxed to 303.784.6110 no later than Monday, Feb.7, 2011, and are subject to a $100 processing fee.
No credit or partial or full refund will be made forfailure to attend after this date. Cancellations bytelephone will not be accepted.
If for any reason, MGMA must cancel one of its programs or turn you away due to limitedattendance, your registration fee will be refundedin full. However, you are responsible for your ownairline and hotel reservations. MGMA cannot beheld accountable for any cancellation chargescaused by program cancellation or attendancelimitations.
Please call the MGMA Service Center toll-freeat 877.275.6462, ext. 1888, if you need to sendsomeone in your place. If the new attendeehas a different MGMA membership status, theregistration fee will be adjusted accordingly. Formore information on administrative policies suchas a complaint or refund, please call the MGMAMeeting and Conferences Department toll-free at877.ASK.MGMA (275.6462), ext. 1875.
DressBusiness casual attire is appropriate for allconference functions, including the receptions.Weather in February can be mild and hotelmeeting rooms cool. Dressing in layers is best formaximum comfort.
Note to those with special needsWe wish to take steps to ensure that no individualwith a disability is excluded, denied services,segregated or otherwise treated differently thanother individuals because of the absence of auxiliary aids or services. If you need any auxiliaryaids or services identified in the Americans withDisabilities Act, call the MGMA Meetings andConferences Department toll-free at 877.ASK.MGMA (275.6462), ext. 1875, before your arrival.
ACMPE credit
The American College of Medical PracticeExecutives (ACMPE) is MGMAs standard-setting and certification body and promotes theprofessional growth of leaders. By developingthe Body of Knowledge for Medical PracticeManagement, ACMPE provides a centralframework for MGMA resources. This program isapproved to receive a maximum of 9 credit hoursas assigned by the ACMPE.
Registration General Information
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Please make copies of this form if more than one person registers. Check here if this is a new address
National MGMA number: _______________________________________ Check here if you only belong to yourlocal/state association
First name: ______________________________________________ Last name: __________________________________
Title: ____________________________________ Preferred name on badge: ___________________________________
Organization: ____________________________ Address: ___________________________________________________
City: __________________________ State: ____________________ ZIP: ______________________________________
Phone: ________________________ Fax: _____________________ E-mail: ___________________________________
A special note to the disabled: Please call MGMAs Meetings and Conferences Department toll-free 877.275.6462,ext. 1875, approximately three weeks prior to your arrival if you have a special need and require accommodation toparticipate in this activity.
REGISTRATION FEES Total Due MGMA State Officer $ 199MGMA State Staff $199
ACMPE State Forum Representative $199
ACMPE Section Forum Coordinator $199
*If your registration is waived, please note waived on the registration form. TOTAL DUE FORFor details regarding reimbursement please visit mgma.com/slc11. REGISTRATION: $
Method of payment (payment must accompany registration):
Check enclosed Charge my credit card VISA MasterCard American Express
Card no.: ________________________________________________________ Expiration date:
Cardholders name: ___________________________________________________________________________________________
Cardholders signature: ________________________________________ Date: ________________________________________
Mail the program registration form(s) with your check, made paya le to MGMA, to the following lock ox address:Medical Group Management AssociationP.O. box 17603Denver, CO 80217-0603
Register by phone toll-free 877.275.6462, ext. 1888 or fax 303.784.6110.
MGMA 2011 State Leaders Conference (LDCNF11)Fe . 11-12, 2011
Program Registration Form
I will attend the welcoming reception on Thursday, Feb. 10.