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