Authorization Bingo - Call List

(Print) Use this randomly generated list as your call list when playing the game. There is no need to say the BINGO column name. Place some kind of mark (like an X, a checkmark, a dot, tally mark, etc) on each cell as you announce it, to keep track. You can also cut out each item, place them in a bag and pull words from the bag.

1. Auth is Poor Quality
2. Auth DOES NOT allow Sensitive Info
3. Patient Signature Date Missing
4. Conditioning Statement Missing
5. Expiration Date/Event Missing
6. Patient Signature Missing
7. Auth in Another Language
8. Purpose of Disclosure Missing
9. Information to be Disclosed Missing
10. HIV/AIDS Clause Missing
11. Re-Disclosure Statement Missing
12. Missing Letter of Rep
13. Who is Releasing Missing
14. Requestor Address does not match Request
15. Auth Needed but not Provided
16. Electronic Signature
17. PoA or Personal Rep
18. Signature Date in the Future
19. Patient Identifier Mismatch
20. Revocation Statement Missing
21. Patient Directive
22. Requested Info differs from Authorized Info
23. Who is Receiving Missing
24. Sensitive Information Missing