Registration Form
AHIMA ID#SOURCE CODE: MX11101
Military/Government ID#Badge Name
First NameMILast NameCredentials
TitleEmployer
Business Mailing Address
Business Fax Number
Email Address (AHIMA does not share e-mail addresses without your permission)
The Delegate badges and meeting materials will be available at the Marriott
New Orleans Hotel.
Emergency Contact
NamePhone
Full Conference Registration 9/28–9/30 (check your selection)
Includes educational tracks, general sessions, Appreciation Celebration, exhibit hall and Welcome Reception.
All other items are priced separately. Student registration does NOT include an Appreciation
Celebration ticket.
Membership Status
On or before 8/25
8/26-9/25
Starting 9/26
R098 Member
$560
$660
R098 Non-Member
$660
$760
R048 Military/Government*
$580
$680
R088 Exhibitors with CEUs**
$495
$495 R038 Emeritus
$315
$315
R078 Student***(see below)
$95
$125
Check here if attending Sunday, 9/27 Student Academy
15E140–Include Full Conference Recordings for additional $145
(must register for above Reg types to purchase recording at this rate)
R110 Exhibit Hall Only $75
$760
$860
$780
$495
$315
$145
*Military/Government discounts are limited to US Military/Government personnel w/valid ID. Please note should
your ID prove to be invalid, your registration will be cancelled and the applicable cancellation fees will be charged
**Must be with a verified exhibiting company during the AHIMA show
***Must be an AHIMA student member for student rate | Academy available to AHIMA student members
registered for convention
Daily Registration (If not attending the full conference)
Fees include general sessions, educational tracks and exhibit hall. All other events priced separately.
Member Status
R113 Member
R113 Non-Member
R114 Military/Government*
$335
$435
$355
Please check day attending:
Attending Attending
Monday, 9/28
Tuesday, 9/29
Attending
Wednesday 9/30
* Military/Government discounts are limited to US Military/Government personnel w/valid ID. Please note should
your ID prove to be invalid, your registration will be cancelled and the applicable cancellation fees will be charged.
Guest Registration ($85)
Limited to spouses, significant others and children 18 and over of fully registered attendees. Includes general sessions
and entrance to exhibit hall only. All other events priced separately. CEU’s not available.
Guest Name:
If you register after September 4,
please pick up your materials in the
registration area at the convention
center.
Delegates: All delegates will be preregistered for the House of Delegates
business meeting through the Volunteer
Services team.
CityStateZip Code
Business Phone Number
NOTE: Badges and tickets will be
mailed to you if you register by
September 4. Be sure to bring the
entire packet to the convention.
Registration for the full convention is a
separate registration that can be done
online at ahima.org/convention, or
through this form.
Registration Cancellation Policy
If you cannot attend the convention, you
may provide a substitute or cancel your
registration. In either case, please notify
AHIMA in writing as soon as possible.
Please refer to our website for our full
cancellation policy. A $125 processing
fee will be assessed prior to August 26,
2015. After that date, the full registration
fee will be forfeited unless cancellation
is due to an emergency. In the event of
an emergency please fax cancellation
request, with an explanation, to AHIMA
Convention at (972) 349-7715. Students
may provide a substitute or forfeit their
registration fee.
AHIMA reserves the right to cancel
any educational session due to lack of
participation. In such a case, attendees
will receive a full refund for the session
or may credit the fee toward another session, if available. Further, AHIMA and
our preferred travel booking agent are
not responsible for any travel arrangement cancellation charges incurred by
event cancellations.
OPT OUT
I am not interested in being contacted
by exhibitors about their latest HIM
products and services. Please remove
my name from the pre- and postconference mailing list.
Registration Form
Clinical Coding Meeting: Saturday 9/26 an Sunday, 9/27 (check your preference)
Membership Status
On or before 8/25
15E102 Member 2 Day
Member 1 Day (check day)
15E102N Non-Member 2 Day
Non-Member 1 Day (check day)
15E102M Military/Govt 2 Day*
Military/Govt 1 Day* (check day)
$405
$295
$505
$395
$425
$315
8/26–9/25
Starting 9/26
$505
Sat., 9/26 15E104
$605
Sat., 9/26 15E104N
$525
Sat., 9/26 15E104M
$605
Sun., 9/27 15E105
$705
Sun., 9/27 15E105N
$625
Sun., 9/27 15E105M
* Military/Government discounts are limited to US Military/Government personnel w/valid ID. Please note should your
ID prove to be invalid, your registration will be cancelled and the applicable cancellation fees will be charged.
Privacy and Security Institute: Saturday 9/26 an Sunday, 9/27
Membership Status
On or before 8/25
15E110 Member
15E110N Non-Member
8/26–9/25
$599
$699
Educational Site Visits
Location
$699
$799
Date
15E144 Ochsner Health System
Until 9/25 Monday 9/28
$40
Online
(Credit Card Only)
www.ahima.org/convention
click on “Registration and Fees”
Starting 9/26
$799
$899
Mail
(Checks or Purchase Orders)
AHIMA
Convention Registration
Dept. 77-6331
Chicago, IL 60678-6331
9/26
$50
Pre-Convention Workshops: ($95 each | please check Workshop)
Saturday, September 26
15E108—The Importance of HIM Involvement
in the Design and Implementation of
Patient Portals
15E109—SNOMED CT: Fundamentals
15E115—Evaluation and Management
(E/M) Coding Workshop
15E116—Fraud and Abuse Concerns for
Anesthesiologist and Pain Management
Sunday, September 27
15E130—Information Governance Workshop
15E131—Grant Writing Strategies
15E132—Democratizing Big Data
15E133—Talking the Talk: Finance Concepts for
the Health Information Professional
15E134—Preventing a Breach: Ten Best Actions
for Securing Your Systems
15E135—Revenue Integrity: Your Chargemaster
May Hold the Key
15E136—Information Governance II
15E137—From Information Management to
Knowledge Management in the Learning Health System: Introduction to
Standards and Systems Interoperability
15E138—“Preserving” EHR for Litigation Purposes Within Information Governance
15E139—Coding Injuries and Poisoning for
ICD-10-CM/PCS
Networking Events: ($65 each)
15E119—Monday, 9/28 | Improving Clinical Documentation in the New World of ICD-10-CM/PCS
15E120—Monday, 9/28 | I Will Take a Mobile Health Solution to Go!
15E124—Monday, 9/28 | AOE Workforce Luncheon $65
15E125—Tuesday, 9/29 | Key Success Factors in Meaningful Use Implementation and Upkeep
15E126—Tuesday, 9/29 | The Role of Terminologies in Interoperability Standards
Other Events (*Tickets for events denoted below are included in full registrations and day of event registrations)
*15E122—Sunday, 9/27 | Welcome Reception Additional Ticket ($50 ea.)______(must be 21 to attend)
*15E101—Tuesday, 9/29 | Appreciation Celebration Additional Ticket ($90 ea.)______(must be 18 to attend)
Educational Tracks
In an effort to better assess appropriate room sizes, please select up to six track sessions per day.
Please note, once onsite you can elect to attend other Tracks of interest. Each of the educational tracks
listed are included with full, student, military/government, exhibitors w/CEUs & daily registrations.
Monday, September 28
Executive
ICD-10
EHR
CDI
Coordinator Care
Privacy & Security
CDI Coordinator Care Global
Quality Reporting Leadership
Population Health
Security
Tuesday, September 29
Wednesday, September 30
Audits
ROI
Data Standards
Coding 1
Patient Portal
Information Governance
Technologies
Physician Practice
Performance Improvement
Informatics
Register Early for Discounted Rates!
Analytics
Payment must accompany form.
Do not mail original after faxing
to avoid duplicate charging.
Phone
(Credit Card payment or questions)
Domestic Calls: (888) 747-8707
International: (972) 349-5807
Payment Information:
• Check (payable to AHIMA)
• Purchase Order (Copy Required)
• Credit Card
Visa
Mastercard
American Express
Discover
Card Number
Name as it appears on the card
Expiration Date
Signature
Physician Practice
Interoperbility
HIE
Fax
(Credit Cards or Purchase Orders)
(972) 349-7715
Applied IG
Security Code