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