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