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