MEDICAL GROUP MANAGEMENT ASSOCIATION

Two days in Denver

can make all the difference
In your leadership.
In your membership.

MGMA 2011 State

Leaders Conference
Feb. 11--12, 2011 • Denver
General Information
Who should attend
The target audience for this conference is officers
and paid staff for MGMA state affiliates. Officers,
chairs and paid staff may participate in the session
that will be most helpful to them and their state
associations. MGMA also welcomes members who
are not currently involved in state leadership but
are interested in pursuing such service. Presidents
of state associations who have identified future
leaders within your association are encouraged to
attend.
Why you should attend
Whether you are a current State MGMA officer,
chair, staff contact, or aspiring state leader, the
MGMA 2011 State Leaders Conference offers
the education and inspiration you need to be a
successful leader.
Learn from your peers — Share experiences,
get practical tools and gain information.
Whatever issues your organization faces — from
vendor relationship building to leadership
development — you’ll return from the MGMA 2011
State Leaders Conference with the knowledge and
skills to tackle the challenge.
Many thanks to our conference sponsor
You’re here for answers, and you’ve come to the right place.
Lanyard sponsor
•2•
Network with your peers — Get hands-on advice and
practical solutions that only your colleagues in
other state MGMAs can provide. You’ll have plenty
of opportunities to catch up with old friends and
connect with new ones.
Conference site
Set against the stunning backdrop of the Rocky
Mountains, the Renaissance Denver Hotel is
conveniently located midway between Denver
International Airport and downtown Denver.
Centered in the Stapleton redevelopment area, the
largest urban redevelopment project in the world,
the hotel is near many attractions. The crown
jewels of the Stapleton area are the new Shops at
Northfield and Dick’s Sporting Goods Park, home
of the Colorado Rapids Major League soccer team.
Join us in the Mile High City!
Let us make you aware of an
array of products and services
to meet your needs.
Spend your networking breaks at
the exhibitor tables, where you’ll
find solutions and build important
relationships.
Schedule at a Glance

Thursday, Feb. 10 Saturday, Feb. 12

Noon-3:00 pm Conference registration open
3:00 pm Shuttles depart hotel
4:00-6:00 pm Welcoming Reception at
MGMA Headquarters
6:00 pm Shuttles depart MGMA
Headquarters
6:00-8:00 am Breakfast in hotel restaurant
(included in room rate)
7:00 am-3:45 pm Conference registration open
8:00-9:15 am General session
Washington Update
9:15-9:45 am Networking break

9:45-10:45 am Concurrent sessions

Friday, Feb. 11 300 Series

6:00-8:00 am Breakfast in hotel restaurant 10:45-11:15 am Networking break

(included in room rate)
11:15 am-12:30 pm Concurrent session
7:00 am-5:00 pm Conference registration open 400 Series

7:30-8:55 am MGMA Joint Council of 12:30-1:30 pm Networking luncheon

Section Officers Meeting
(invite only)
7:30-8:55 am State Staff Meeting
9:00 am-noon Individual Section Council
of State Leaders (COSL)
Meetings
1:30-2:00 pm Speaker Showcase session
$tart a new discussion
2:00-2:30 pm Speaker Showcase session
Strengths-Based Leadership:
Leveraging Talent for
Organizational Outcomes

Noon-1:00 pm Keynote session 2:30-3:15 pm Networking break

MGMA/ACMPE Update
3:15-4:15 pm Hot Topic Round Tables
1:00-2:00 pm Concurrent sessions
100 series

2:00-2:30 pm Networking break

2:30-3:00 pm Speaker Showcase session

Impact of Individuals on
Lobbying Efforts

3:00-3:30 pm Speaker Showcase session

Are You Surviving or
Thriving?

3:30-4:00 pm Networking break

4:00-5:00 pm Concurrent sessions

200 Series

•3•
 Conference Schedule

Thursday, Feb. 10 9:00 am-noon

Individual MGMA Section Council of State
4:00-6:00 pm
Leaders (COSL) meeting
Welcoming Reception at MGMA Each section meets individually with its state
Headquarters leaders and staff. All participants (state and
Join your colleagues at the MGMA Headquarters national) attend their respective section meeting.
for drinks and hors d’oeuvres.
Noon-1:00 pm

Friday, Feb. 11 Keynote session: MGMA/ACMPE Update

(lunch will be served)
6:00-8:00 am Organizational Governance

Breakfast in hotel restaurant William F. Jessee, MD, FACMPE, president and chief executive
(included in room rate) officer, Medical Group Management Association, Englewood,
Colo.; Shena Scott, MBA, FACMPE, executive director, Brevard
Anesthesia Services PA and chair, MGMA Board of Directors;
7:00 am-5:00 pm and Alan D. Winkler, MHSA, FACMPE, vice president of clinic
operations, St. Vincent Health System, Little Rock, Ark. and chair,
Conference registration open ACMPE Board of Directors

Get an update on association business trends from

7:30-8:55 am
Joint Council of Section Officers Meeting
(invite only)
MGMA national section officers will meet and
discuss topics of concern and interest.
the MGMA president and the newly elected board
chairs. During this presentation, you will discover
the trends, challenges and opportunities affecting
Associations in the coming year.

7:30-8:55 am
MGMA State Staff Meeting
This session is always valued whether you are
a new or seasoned state staff contact. Join your
fellow state staffers to discuss issues unique to your
role.

Many thanks to the planning committee for the MGMA 2011 State Leaders Conference:

Nancy Enos, FACMPE, CPC-I, CEMC, consultant, Nancy Enos
Medical Consulting, Warwick, R.I., MGMA Eastern Section
Chair
Rosemarie Kuntz, MBA, FACMPE, clinical department
manager, Mid Dakota Clinic, PC, Bismarck, ND, MGMA
Midwest Section Chair
Jean Hansen, MBA, FACMPE, chief executive officer,
Gastroenterology Consultants, Independence, MO, MGMA
Southern Section Chair
Judy Montgomery, CPA, MBA, FACMPE, practice
administrator, Cardiovascular Surgery of Southern Nevada,
Las Vegas, NV, MGMA Western Section Chair
Mindy Zaubi, executive director, Illinois MGMA, Ohio
MGMA and South Florida MGMA, Woodstock, Ga.
Nancy A. Martin, MBA, CMPE, administrator, Canton
Aultman Emergency Physicians, Canton, Ohio, MGMA
Midwest Section Board Representative

•4•
Conference Schedule
1:00-2:00 pm
Concurrent sessions – 100 series
101. Membership Recruitment and Retention
Business Operations
Dana Guilfoyle, vice president, Communications and Marketing,
Medical Group Management Association, Englewood, Colo.,
Mindy Zaubi, executive director, Illinois MGMA, Ohio MGMA and
South Florida MGMA, Woodstock, Ga., and Melissa O. Wilson,
executive director, Tennessee MGMA and Kentucky MGMA,
Brentwood, Tenn.
Everyone knows it is more expensive to attract
a new customer than to keep an existing one.
As association professionals, our lifeline is our
membership base. The explosion of digital media
and business intelligence software provides the
opportunity to deliver relevant communications at
prime “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 revamped
its marketing efforts via digital marketing
• Examine different methods and testing processes,
and leave armed with tips and tricks to
implement at your association
102. Key Insights from a Legislative Aide
Risk Management
Speaker TBD
Legislative aides provide support and access to
elected officials. Learn first-hand from a legislative
aide how to get time with your legislator, the best
way to present to your legislators and how to be
successful in your grassroots efforts.
This session will provide you with the knowledge to:
• Describe how legislative aides can benefit in
grassroots efforts
• Discuss the best ways to contact your legislators
•5•
103. All Chiefs, No Indians: Leading
Volunteer Leaders
General Competencies: Leadership Development
Deb Wiggs, FACMPE, chief executive officer, Trinity Management
Solutions, Bellingham, Wash.
Maintaining effective leadership in a professional
organization of leaders can either hone or dull
your own leadership skills. What are some of
the critical requirements needed to support your
leadership efforts and provide your association
with both consistent and persistent leadership?
This session will give you some ideas and
components that provide a framework for effective
management and leadership in a volunteer
organization, 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 traits
of leaders
• Identify how to handle difficult situations
104. State ACMPE Forum Representatives
Round Table
Strengthen your relationship with your MGMA
state association, promote ACMPE effectively and
serve your state members by coming prepared to
share ideas with other Forum Representatives.
This session will provide you with the knowledge to:
• List three ways to promote ACMPE and serve
your state members
2:00-2:30 pm
Networking break
Conference Schedule
2:30-3:00 pm
Speaker Showcase session: Impact
of Individuals on Lobbying Efforts
Risk Management
Joel Blackwell, speaker and author, Washington, D.C.
Communication with elected officials is the key
to lobbying efforts. During this session, you will
learn how individuals can impact public policy by
communicating with elected officials, which kinds
of communications work best, why relationships
matter and how to deal with the competition for
attention caused by the deluge of information
pouring 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 You
Surviving or Thriving?
Financial Management
James A. Stroud, CPA, member, Warren, Averett, Kimbrough and
Marino LLC, Birmingham, Ala.
There are forces in our culture that press on us to
the point of reducing us to a survival mentality.
This session will bring the problem into focus and
illustrate that the solution to living a positive,
impactful and enthusiastic life lies within each of
us.
•6•
3:30-4:00 pm
Networking break
4:00-5:00 pm
Concurrent sessions – 200 Series
201. Association Finances – Inquiring Minds
Want to Know
Financial Management
James A. Stroud, CPA, member, Warren, Averett, Kimbrough and
Marino LLC, Birmingham, Ala.
Accounting processes for an association must
satisfy governmental reporting requirements, but
the same processes must exceed the expectations
of your officers, board and members. And all must
be accomplished without an improper use of funds
happening on your watch. This session will enable
you to identify the external and internal interested
parties, and understand the distinction between
financial data and useful association management
financial information.
This session will provide you with the knowledge to:
• Recognize how time invested in the chart of
accounts will provide better information for
association management
• Learn how to connect financial reporting formats
with association goals
• Describe how to lessen the likelihood that
a fraud or impropriety occurs under your
leadership
Conference Schedule
202. Your Association’s Role in Grassroots
Efforts
Risk Management
Joel Blackwell, speaker and author, Washington, D.C.
Your organization can have a large impact on
public policy. During this session, the speaker will
review best models and practices for maximizing
the impact of your organization on public policy.
To have the most impact, your association will
need to create a key contact network that will
recruit, motivate, educate and activate your
members to communicate with elected office
holders.
This session will provide you with the knowledge to:
• Describe the importance of reward and
recognition, the role of leadership of board
and officers, and why members are reluctant to
engage in political communication and how to
overcome that reluctance
203. Deepening Your Volunteer Pool
Leadership Development
Betsy Holt, MSS, director of member engagement, Medical Group
Management 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 good
job, but getting some new blood and new ideas
would be good, too. How do you expand your
volunteer pool? In this interactive session, we’ll
take a look at some key findings from volunteer
research that can help us understand how to make
it easier for your members to volunteer. We’ll
share some best practices and success stories from
MGMA’s national and state offices.
This session will provide you with the knowledge to:
• List three key ideas that will help you grow your
volunteer pool
• Describe three barriers that prevent potential
volunteers from stepping up
•7•
204. State Staff Round Table*
Information Management
Mindy Zaubi, executive director, Illinois MGMA, Ohio MGMA and
South Florida MGMA, Woodstock, Ga.
During this interactive discussion, state staff will
discuss some of the common issues facing MGMA
state associations as well as share ideas and best
practices.
This session will provide you with the knowledge to:
• Identify new opportunities for implementation
for your state association
*State staff only.
205. Overview of ACMPE Certification:
Taking the Trip from Nominee to Certified
Member to Fellow*
Beth A. Balen, FACMPE, Western Section Forum Coordinator,
ACMPE, and Maria F. Petro, FACMPE, Eastern Section Forum
Coordinator, ACMPE
Participating in the American College of Medical
Practice Executives (ACMPE), MGMA’s standard-
setting and certification body, is the best way to
demonstrate your leadership and competence
in medical practice management. ACMPE offers
nationally recognized board certification and
Fellowship programs. Gain an understanding of
the process and requirements necessary to attain
ACMPE board certification and Fellowship, as well
as the resources and programs to get you there.
Identify ways that ACMPE certification can further
your professional development and personal
growth.
This session will provide you with the knowledge to:
• Identify ways that ACMPE board certification
and Fellowship can further your professional
development and personal growth
*ACMPE Forum representatives received waived
registration fees for the conference, and a $250 travel
stipend to encourage attendance.
Conference Schedule
Saturday, Feb. 12
6:00-8:00 am
Breakfast in hotel restaurant
(included in room rate)
7:00-4:15 pm
Conference registration open
8:00-9:15 am
General session: Washington
Update
Risk Management
Allison Brown, government affairs representative of Medical
Group Management Association, Washington, D.C.
Medical practices often receive late and
contradictory information on the actions of
Capitol Hill and the administration affecting
health care and daily administrative burdens.
Provided in this update will be timely information
on the regulatory and legislative issues under
consideration by the administration and the
Congress. Highlights contain MGMA’s advocacy
objectives for 2011 and the important grassroots
role that members must play in achieving
advocacy success.
This session will provide you with the knowledge to:
• Discuss proposed regulatory and legislative
changes affecting medical groups
• Identify recent changes in Medicare
reimbursement and program policies
• Recognize the challenges practices will face
implementing and complying with new
regulations
• List ways you can effectively participate in
advocacy efforts
9:15-9:45 am
Networking break
•8•
9:45-10:45 am
Concurrent sessions – 300 Series
301. Lobbying 101
Risk Management
Anders Gilberg, MGA, vice president of public and private
economic affairs; Allison Brown, government affairs
representative, both of the Medical Group Management
Association, Washington, D.C.
In this session, you will learn strategies for
effective lobbying. Identify the critical resources
and plan how to manage the most effective
lobbying effort.
This session will provide you with the knowledge to:
• Discover ways to maximize advocacy and
minimize the cost
• Explain the common motivators and strategies
for getting legislators to support your issues
302. Strategic Planning from the Ground Up
Organizational Governance
Kenneth T. Hertz, FACMPE, principal consultant, Medical Group
Management Association, Englewood, Colo.
The saying goes, “If you don’t know where you’re
going, there’s a good chance you won’t get there.”
In order for organizations to achieve their goals,
they must have a mission, vision and values
supported by a thoughtful and sound strategic
plan. Working from the group up, this session
will cover the foundational aspects of strategic
planning — vision, mission and values — then
address the process and approach for developing
the strategic plan.
At this session, participants will:
• Discuss the importance of mission, vision and
values, and how to ensure their relevance today
• Discover how to identify and include key
stakeholders in the strategic planning process
• Explain how to orchestrate the process for
development of a strategic plan
• Recognize how to develop a strategic plan for
their organization
Conference Schedule

303. Getting Leaders from Your 10:45-11:15 am

Volunteer Pool Networking break
Organizational Governance

Nancy M. Enos, FACMPE, CPC-I, CEMC consultant, Nancy Enos

Medical Consulting, Warwick, R.I.
Succession planning is an important responsibility
of state officers. State leaders often struggle with
the selection of the best candidates for future
board positions. This session will discuss ways to
identify the best possible candidates for leadership
in your volunteer pool. Leaders must recognize
and avoid pitfalls of volunteers who say “yes”
when invited to fill a roll, only to disappear or fall
short 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, evaluate
and mentor the right people to ensure positive
leadership in the future of the state association
304. State Staff session*
Business Operations
11:15 am-12:30 pm
Concurrent session – 400 Series
401. Effective Lobbying at the State Level
Risk 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 M
Healthcare Consultants, Denver
Your state association can have a big legislative
impact at the local level. There are many ways to
“rally the troops,” and make significant headway,
during this session, you will hear several options.
The panelists will also discuss the governance
structure at their state association that supports
advocacy efforts.
This session will provide you with the knowledge to:

Mindy Zaubi, executive director, Illinois MGMA, Ohio MGMA and • Describe various activities that the state
South Florida MGMA, Woodstock, Ga. association can implement to advance legislative
issues
During this interactive roundtable discussion, state
• Discuss different types of governance structures
volunteers will share best practices for leading
that support advocacy at the local
their association into the future and on providing
services to their membership.

This session will provide you with the knowledge to:

• Identify new opportunities for implementation
for your state association

*State staff only

•9•
Conference Schedule

402. From Plan to Action: You’ve Got Your
Plan, Now What?
Organizational Governance
Kenneth T. Hertz, FACMPE, principal consultant, MGMA,
Englewood, Colo.
The payoff for strategic planning is the
achievement of strategic goals and objectives.
Many organizations complete the planning
process successfully but fail to achieve the
desired results. This session presents tools and
techniques that leaders can use to ensure success
in the deployment of their strategic plan. The
presentation will be didactic in nature, with
specific examples provided that demonstrate both
success and failure.
This session will provide you with the knowledge to:
• Discuss how to apply the tools and techniques
presented 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 strategic
planning along with the concept of a looped
process
403. Managing Volunteers
Leadership Development
404. How to use your ACMPE State Forum
Representative to Enhance your Members’
Experience
Venus K. Biskis, FACMPE, Midwest Section Forum Coordinator,
ACMPE, and Susan Childs, FACMPE, ACMPE Forum Representative,
North Carolina
What is the benefit of promoting professional
certification to your state members? Participation
in the American College of Medical Practice
Executives (ACMPE), MGMA’s standard-setting and
certification body, is the best way to demonstrate
leadership and competence in medical practice
management. This session is designed for state
leaders to learn how to best utilize your ACMPE
state forum representatives to provide your state
members the opportunity to pursue certification
and Fellowship in ACMPE. Following this session,
you will be able to use ideas from other state
associations to encourage your members to pursue
the benefits of ACMPE board certification and
Fellowship. Current state Forum representatives
are also encouraged to attend to share successful
activities.
This session will provide you with the knowledge to:
• Incorporate ideas from other state associations to
encourage your members to pursue the benefits
of ACMPE board certification and Fellowship

Betsy Holt, MSS, director of member engagement, Medical Group

Management Association, Englewood, Colo.

Volunteers can extend the human capital of your

organization. Furthermore, volunteers who have a
good experience will be more satisfied and possess
greater loyalty to your group. How can you create
a system to manage volunteers that effectively
uses their skills and time, while ensuring “a
good time had by all”? In this session, we will
discuss key elements of different approaches to
volunteer management and describe the volunteer
management program being built at MGMA
national.

This session will provide you with the knowledge to:

• Describe important attributes of a volunteer

management program

• 10 •
Conference Schedule

12:30-1:30 pm healthcare organizations select, measure, develop

Networking luncheon
1:30-2:00 pm
Speaker Showcase session:
$tart a new discussion
Financial Management
Todd Evenson, MBA, assistant director of survey operations,
Medical Group Management Association, Englewood, Colo.
Health reform, physician shortages and
generational differences impact physician
compensation. Ultimately, these factors affect the
way you recruit and retain physicians. In order to
meet tomorrow’s challenges, you will need to be
keenly aware of the evolving market conditions
that 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 the
way you recruit
and channel the careers of their people, they can
build an entire culture around the strengths of
each individual.
This session will provide you with the knowledge to:
• Describe how physician groups and healthcare
organizations have driven growth by focusing on
the talent of their employees and departments
• Discover strategies to create, implement and
sustain 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 Tables
Business Operations

• Understand generational differences that impact During this interactive round table discussion,
what each physician values state volunteers will share best practices for leading
their association into the future and on providing
• Explore tomorrow’s compensation and benefits
services to their membership.
packages
This session will provide you with the knowledge to:
2:00-2:30 pm • Identify new opportunities for implementation
for your state association
Speaker Showcase session:
Strengths-Based Leadership:
Leveraging Talent for Round Table topics include governance, products
Organizational Outcomes and services, communication and program
planning
General Competencies: Leadership

Laurie K. Baedke, FACHE, CMPE, president, The LIFEworks Group,

Omaha, Neb.

How can leaders tap in to the true potential of

their organization’s greatest asset, their employees?
Today, a company’s market value depends less on
its tangible assets and more on its human capital.
Great leaders and great organizations must not
only accommodate the fact that each employee is
different, they must capitalize on those differences.
They must watch for clues to each employee’s
natural talents and then position and develop each
employee so that his or her talents are transformed
into bona fide strengths. By changing the way

• 11 •
Registration General Information
Hotel
Renaissance Denver Hotel
3801 Quebec Street, Denver, CO 80201
Phone: 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 you
at The Renaissance Denver Hotel at the reduced
rate. Call the hotel directly for sleeping-room
reservations and ask for the MGMA 2011 State
Leaders Conference block and rate. Discounted
rooms are available until Monday, Jan. 24, 2011
or until they sell out. After this date, reservations
at the conference rate will be accepted on a space-
available basis only.
A first night’s deposit, by check, cash or credit
card, including tax, must accompany all
reservation requests
Hotel transportation
Complimentary transportation is available to and
from Denver International Airport. Pick up at the
airport is on baggage claim Level 5 on the west
side 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 schedule
your shuttle time back to the airport at the hotel
in advance, not that morning, as space is limited.
Reimbursement for State Leaders
Conference
MGMA will waive the registration fee to the
State Leaders Conference for one (1) state board
member, one (1) state staff (non-transferable)
and for one (1) ACMPE Forum representative
(non-transferable) to attend the conference. In
addition, MGMA will also provide each state a
reimbursement of up to $250 for a state board
member and the ACMPE Forum representative.
In addition, MGMA will provide each state a
reimbursement of up to $250 for a state board
member and ACMPE will provide each state a
reimbursement of up to $250 for a State Forum
Representative.
Cancellation policy
All registration cancellations must be received
in writing to the MGMA Service Center, 104
Inverness Terrace East, Englewood, CO 80112, or
faxed to 303.784.6110 no later than Monday, Feb.
7, 2011, and are subject to a $100 processing fee.
• 12 •
No credit or partial or full refund will be made for
failure to attend after this date. Cancellations by
telephone will not be accepted.
If for any reason, MGMA must cancel one of
its programs or turn you away due to limited
attendance, your registration fee will be refunded
in full. However, you are responsible for your own
airline and hotel reservations. MGMA cannot be
held accountable for any cancellation charges
caused by program cancellation or attendance
limitations.
Please call the MGMA Service Center toll-free
at 877.275.6462, ext. 1888, if you need to send
someone in your place. If the new attendee
has a different MGMA membership status, the
registration fee will be adjusted accordingly. For
more information on administrative policies such
as a complaint or refund, please call the MGMA
Meeting and Conferences Department toll-free at
877.ASK.MGMA (275.6462), ext. 1875.
Dress
Business casual attire is appropriate for all
conference functions, including the receptions.
Weather in February can be mild and hotel
meeting rooms cool. Dressing in layers is best for
maximum comfort.
Note to those with special needs
We wish to take steps to ensure that no individual
with a disability is excluded, denied services,
segregated or otherwise treated differently than
other individuals because of the absence of
auxiliary aids or services. If you need any auxiliary
aids or services identified in the Americans with
Disabilities Act, call the MGMA Meetings and
Conferences Department toll-free at 877.ASK.
MGMA (275.6462), ext. 1875, before your arrival.
ACMPE credit
The American College of Medical Practice
Executives (ACMPE) is MGMA’s standard-
setting and certification body and promotes the
professional growth of leaders. By developing
the Body of Knowledge for Medical Practice
Management, ACMPE provides a central
framework for MGMA resources. This program is
approved to receive a maximum of 9 credit hours
as assigned by the ACMPE.
Program Registration Form

MGMA 2011 State Leaders Conference (LDCNF11)

Feb. 11-12, 2011
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 your
local/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 MGMA’s 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 to
participate in this activity.

Registration

fees Total Due

MGMA State Officer $ 199

MGMA 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 FOR
For details regarding reimbursement please visit mgma.com/slc11. REGISTRATION: $

❏ I will attend the welcoming reception on Thursday, Feb. 10.

Method of payment (payment must accompany registration):

❏ Check enclosed ❏ Charge my credit card ❏ VISA ❏ MasterCard ❏ American Express

Card no.: _________________________________________________________ Expiration date:

Cardholder’s name:____________________________________________________________________________________________

Cardholder’s signature:_________________________________________ Date:_________________________________________

Mail the program registration form(s) with your check, made payable to MGMA, to the following lockbox address:
Medical Group Management Association
P.O. Box 17603
Denver, CO 80217-0603

Register by phone toll-free 877.275.6462, ext. 1888 or fax 303.643.4439.

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