(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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Employer collaboration for RTW documented
19.
Complete Initial Assessment within 5 days
LASER techniques documented when appropriate
25.
Document network status of providers
PT/OT updates every 14 days
Symptom progression monitoring plan documented
15.
Use LASER framework with resistant IW
ICD-10 code included with diagnosis
Document medication compliance,
28.
Proper template format used (!bha)
PT/OT updates every 14 days
Share job description with ALL providers,
Concentration difficulties noted
IW follow-up within 2 days of office visit
Document RTW progress against ODG
IW follow-up within 2 days of office visit
Employer collaboration for RTW documented
POA addresses medication management
Concise description of behavioral issue (1-2 lines)
3.
Include CPT codes for procedures
ODG benchmarks referenced
Network providers properly documented
13.
Healthwise resources provided for behavioral health
Document RTW barriers
Specific actions with exact dates documented
4.
Provider follow-up within 1 day of office visit
5.
Provider follow-up within 1 day of office visit
Monthly IW contact documented
ODG benchmarks referenced
23.
Concentration difficulties noted
14.
RTW negotiation based on ODG guidelines
Impact of worry on recovery documented
Document CM Analysis in OV note
Provider follow-up within 1 day of office visit
IW/Provider/Employer contact within 2 business days
Behavioral Health Alert properly documented
1.
Psychosocial barriers to recovery identified
10.
ODG benchmarks referenced
Share job description with ALL providers,
Functional improvement documented
Include CPT codes for procedures,
LASER techniques documented when appropriate
Job description shared with all providers
Confounding factors updated
LASER techniques documented when appropriate
RTW negotiation based on ODG guidelines
18.
CM Analysis includes treatment plan assessment
Templates completed per PMA standards
12.
Active listening techniques documented
12.
POA addresses psychosocial barriers
LASER technique used with resistant IW
7.
Document employer accommodation status,
Healthwise education documented
15.
LASER technique used with resistant IW
Alert addressed within 24 hours
Adjuster update within 1 day of appointment findings
Treatment requests properly facilitated
14.
POA addresses psychosocial barriers
Templates completed per PMA standards
Specific actions with exact dates documented
Special Handling Instructions followed
21.
Special Handling Instructions followed
POA addresses psychosocial barriers
11.
Concise description of behavioral issue (1-2 lines)
Ongoing IW education documented
16.
Alert addressed within 24 hours
6.
IW/Provider/Employer contact within 2 business days
2.
Transitional duty options explored
Symptom progression monitoring plan documented
Document medication compliance
Network providers properly documented
ICD-10 code included with diagnosis
POA addresses medication management
Treatment requests properly facilitated
Motivational interviewing technique documented
ICD-10 code included with diagnosis
2.
Include CPT codes for procedures,
Behavioral Health Alert properly documented
Include ICD-10 codes with diagnosis,
26.
Treatment requests properly facilitated
Proper template format used (!bha)
11.
Concise description of behavioral issue (1-2 lines)
Create specific Plan of Action
Initial Assessment completed within 5 business days
Healthwise resources provided for behavioral health
8.
Specific actions with exact dates documented
Healthwise resources provided for behavioral health
Symptom progression monitoring plan documented
Impact of worry on recovery documented
13.
Include ICD-10 codes with diagnosis,
IW follow-up within 2 days of office visit
4.
Transitional duty options explored
Employer collaboration for RTW documented
Transitional duty options explored
20.
Functional improvement documented
Templates completed per PMA standards
Initial Assessment completed within 5 business days
3.
Document IW education with Healthwise
Healthwise education documented
Share job description with provider
Adjuster update within 1 day of appointment findings
Follow up on ancillary services
Initial adjuster contact within 1 business day
Job description shared with all providers
17.
Include CPT codes for procedures,
27.
Ongoing IW education documented
Concentration difficulties noted
Adjuster update within 1 day of appointment findings
6.
Include ICD-10 codes with diagnosis,
Document ODG benchmarks
Job description shared with all providers
Monthly IW contact documented
8.
Document MED for narcotic prescriptions
Document medication compliance,
Psychosocial barriers to recovery identified
Document psychosocial barriers
PT/OT updates every 14 days
7.
Translate medical terms to layman's terms
Use only approved abbreviations,
31.
Alert addressed within 24 hours
Impact of worry on recovery documented
Healthwise education documented
Use only approved abbreviations,
Psychosocial barriers to recovery identified
Initial adjuster contact within 1 business day
CM Analysis includes treatment plan assessment
Proper template format used (!bha)
Document employer accommodation status
Active listening techniques documented
Share job description with ALL providers,
30.
Contact adjuster within 1 business day
Network providers properly documented
Motivational interviewing technique documented
9.
Ongoing IW education documented
Use only approved abbreviations
Confounding factors updated
Comorbidities properly documented
22.
Monthly IW contact documented
Document PT updates every 14 days
Comorbidities properly documented
CM Analysis includes treatment plan assessment
9.
Contact provider within 1 day of OV
Use only approved abbreviations,
Active listening techniques documented
Follow up with IW within 2 days post-OV
Document employer accommodation status,
29.
Document medication compliance,
Functional improvement documented
24.
Behavioral Health Alert properly documented
Document current functionality
Confounding factors updated
5.
Document employer accommodation status,
Special Handling Instructions followed
Include ICD-10 codes with diagnosis
LASER technique used with resistant IW
IW/Provider/Employer contact within 2 business days
Motivational interviewing technique documented
Initial Assessment completed within 5 business days
