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