ISP Review - 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. Plan Type
2. Unit Cost
3. Initial ISP Dvlpmnt Date
4. Total Waiver Cost/Day
5. Parental Payment
6. Start/End Dates
7. Outcome Number
8. Plan Review/ Update Verific.
9. Medicaid Cost Share
10. Name Parent(s) or Guardian
11. Current ISP Completion Date
12. Participant Informed Rights & Choice
13. Service Provider Contact Info
14. Functional Screen Date
15. Participant Signature
16. Date Signed
17. Daily Cost
18. Service Code Number
19. Service Name
20. Care Level
21. Outlier Rate
22. Funding Source
23. Current Living Arrangmnt
24. Authorized Units of Service & Frequency