Central Indiana Chapter MarchMeeting

Topic: “Motivating Physicians to Document for ICD-10”

Speaker: Carol Hoppe, CPC, CPC-I, CCS

This program has been approved for 2.0 CEUs

Date:March 13, 2014

Time:7:30am to 10:00am

Meeting location: Westview HealthPlex, 3660 Guion Rd, #101, Indianapolis, IN 46222. Phone 317.920.7400

Link for directions to facility:

Please complete one form for each person even if paying for all with one check.

Name ______

Address ______

City______State ______Zip ______

Phone Number: ______Fax ______

Organization ______Job Title ______

E-mail address ______

Are you an AAPC member? [ ] Yes [ ] No If yes, AAPC Member # ______

Indicate certification: [ ] CPC [ ] CPC-H [ ] CPC-P [ ] CIRCC

Other certifications: ______

Early Bird Registration fee due by 3/7/14: $20

Registration fee after 3/7/14: $30 Members and Non-member price is $35

Payment option: ☐ Check enclosed☐ Pay via PayPal

Mail your registration and check to: NEW!! PAYPAL Credit/Debit Payment Option:

AAPC Central Indianapolis Chapter Mail or email your registration form.

C/O Kim Dickerson & Cindy Stephenson See page two for additional payment instructions

PO Box 252

Whitestown, IN 46075

Make check payable to Central Indiana Chapter of AAPC Amount enclosed $ ______

Please Note: Handouts will be emailed to paid registrants prior to the meeting. Handouts will not be provided at the meeting.

For questions contact:

Ellen Risotti-Hinkle

317-431-8307

We are pleased to offer you a new payment option this year via PayPal! You may pay for meetings and other chapter events using a credit/debit card or through your bank account. Please note that there is a small transaction fee for utilizing this service, $1.00 per meeting or $5.00 for all meetings for the year. This transaction fee will need to be added to the amount of the cost of the meetings you are registering to attend.

To make payment via PayPal, follow these steps:

1. Go to PayPal (

2. Login to your account (or create an account if you don’t have one yet)

3. Click on the tab at the top that reads “Send Money”

4. Enter payment information:

  • To:
  • Amount: enter the total amount you are paying including additional processing fees ($1.00 per each meeting or $5.00 for all meetings)
  • Choose: “I’m paying for goods or services”

5. Click “continue”

6. Select payment method (you can enter credit/debit card information or attach a bank account, etc.)

7. Choose “no shipping required” for shipping address

  • Please note: we will not ship any materials to you, handouts will be emailed prior to the meeting

8. Complete the Email to Recipient section as follows:

  • Subject: Early Bird Chapter Meeting Payment
  • Message: Payment for early bird chapter meetings

9. Click “Send Money”

10. Mail or email completed registration form to:

AAPC Central Indianapolis Chapter

C/O Kim Dickerson & Cindy Stephenson

PO Box 252

Whitestown, IN 46075

Email:

For questions contact:

Ellen Risotti-Hinkle

317-431-8307