FLORIDACONTRATORNUMBER(GIVEJURISDICTION& #)CLAIMS FORM(WHICH AREACCEPTABLE?)TOB 133(WHATIS?)5THLEVELAPPEAL(NAME)SNF 3RDDIGIT(CONSISTOF WHATNUMBER?)1STLEVELAPPEAL(NAME?)PTAN(STANDSFOR/MEANING?)REVENUECODE(37X)AFFIRMATION(MEANING)BENEFITPERIOD(DAYS?)CONDITIONALPAYMENT(MEANING)PRVN(MEANING?)ELIGIBILITY(HOUSEDIN WHATSYSTEM?)ADACERTIFICATION(USED FOR?)HIMR-GHOD(MEANING?)3 INQUIRESPER CALLIOM(WHICHPUB?)RTP(MEANING?)HIMR(USEDFOR?)REVERSAL(MEANING?)MAMMOGRAPHYCERTIFICATION(FISS WHATPAGE?)BENEVERIFICATIONUPDATEINFO IN FISS(USINGWHATVALUES?)PROVIDERVERIFICATIONFISSSCREENPG 04(USEDFOR?)FLORIDACONTRATORNUMBER(GIVEJURISDICTION& #)CLAIMS FORM(WHICH AREACCEPTABLE?)TOB 133(WHATIS?)5THLEVELAPPEAL(NAME)SNF 3RDDIGIT(CONSISTOF WHATNUMBER?)1STLEVELAPPEAL(NAME?)PTAN(STANDSFOR/MEANING?)REVENUECODE(37X)AFFIRMATION(MEANING)BENEFITPERIOD(DAYS?)CONDITIONALPAYMENT(MEANING)PRVN(MEANING?)ELIGIBILITY(HOUSEDIN WHATSYSTEM?)ADACERTIFICATION(USED FOR?)HIMR-GHOD(MEANING?)3 INQUIRESPER CALLIOM(WHICHPUB?)RTP(MEANING?)HIMR(USEDFOR?)REVERSAL(MEANING?)MAMMOGRAPHYCERTIFICATION(FISS WHATPAGE?)BENEVERIFICATIONUPDATEINFO IN FISS(USINGWHATVALUES?)PROVIDERVERIFICATIONFISSSCREENPG 04(USEDFOR?)

MEDICARE PART A - 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.


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  1. FLORIDA CONTRATOR NUMBER (GIVE JURISDICTION & #)
  2. CLAIMS FORM (WHICH ARE ACCEPTABLE?)
  3. TOB 133 (WHAT IS?)
  4. 5TH LEVEL APPEAL (NAME)
  5. SNF 3RD DIGIT (CONSIST OF WHAT NUMBER?)
  6. 1ST LEVEL APPEAL (NAME?)
  7. PTAN (STANDS FOR/MEANING?)
  8. REVENUE CODE (37X)
  9. AFFIRMATION (MEANING)
  10. BENEFIT PERIOD (DAYS?)
  11. CONDITIONAL PAYMENT (MEANING)
  12. PRVN (MEANING?)
  13. ELIGIBILITY (HOUSED IN WHAT SYSTEM?)
  14. ADA CERTIFICATION (USED FOR?)
  15. HIMR- GHOD (MEANING?)
  16. 3 INQUIRES PER CALL IOM (WHICH PUB?)
  17. RTP (MEANING?)
  18. HIMR (USED FOR?)
  19. REVERSAL (MEANING?)
  20. MAMMOGRAPHY CERTIFICATION (FISS WHAT PAGE?)
  21. BENE VERIFICATION
  22. UPDATE INFO IN FISS (USING WHAT VALUES?)
  23. PROVIDER VERIFICATION
  24. FISS SCREEN PG 04 (USED FOR?)