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