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2021 AHCC Committees Application
Complete this form to apply for a position on an AHCC Committee. See this AHCC
blog post
for links to the Scopes of Work for all AHCC Committees. Note: You must be an AHCC member to serve on an AHCC committee.
1.
Please provide your name, credentials, and contact information.
Name
Credentials
Company/Organization
Address
City/Town
State/Province
ZIP/Postal Code
Email Address
Phone Number
2.
Please indicate the type of organization for which you work.
As a consultant
For an agency
For an outsourced services provider
Other (please specify)
3.
How long have you worked in home health or hospice?
1-5 years
5-10 years
10-15 years
15-20 years
20-25 years
25 or more years
4.
Are you a BMSC credential holder? (Please note, all certification committee members must hold at least one BMSC credential.)
Yes
No
*
5.
Which BMSC credentials do you hold? (Select all that apply.)
(Required.)
HCS-D
HCS-O
HCS-H
HCS-C
6.
Please upload your head shot and professional bio in one file.
Choose File
No file chosen
7.
Which AHCC Committee would you like to serve on? (Select all that apply.)
Home Care Coding Specialist – Hospice (HCS-H) BMSC Certification Committee
Home Care Coding Specialist – Diagnosis (HCS-D) BMSC Certification Committee
Home Care Specialist - Compliance (HCS-C) BMSC Certification Committee
Home Care Clinical Specialist - OASIS (HCS-O) BMSC Certification Committee
AHCC Awards Committee
AHCC Advocacy Committee
AHCCtober Committee
Documentation Integrity Committee
8.
Please describe your level of experience with the subject area covered by the exam the committee you wish to join. Please include the length of time you have been working in this area and how you achieved your experience.
9.
Do you have any previous experience on a certification committee or board? If so, please describe.
Describe any committee experience
Describe any board experience
10.
Why do you want to serve on an AHCC committee?
11.
What's one thing you would like to see the AHCC committee you are interested in serving on improve through its work?
12.
What's one way AHCC and BMSC can better promote certification among home health and hospice professionals?
13.
This position requires volunteer hours during traditional 8 a.m. to 5 p.m. work hours. Have you obtained permission from your direct manager/supervisor to participate in meetings, email correspondence, and other like responsibilities?
Yes
No
