Use onlyapprovedabbreviations,TransitionaldutyoptionsexploredEmployercollaborationfor RTWdocumentedMonthly IWcontactdocumentedLASERtechniquesdocumentedwhenappropriateAlertaddressedwithin 24hoursPsychosocialbarriers torecoveryidentifiedLASERtechniqueused withresistant IWSpecificactions withexact datesdocumentedRTWnegotiationbased onODGguidelinesIncludeICD-10codes withdiagnosis,Documentmedicationcompliance,ActivelisteningtechniquesdocumentedICD-10 codeincludedwithdiagnosisIW/Provider/Employercontact within 2business daysNetworkprovidersproperlydocumentedInitialAssessmentcompletedwithin 5business daysAdjusterupdate within1 day ofappointmentfindingsConcisedescriptionof behavioralissue (1-2lines)MotivationalinterviewingtechniquedocumentedComorbiditiesproperlydocumentedHealthwiseresourcesprovided forbehavioralhealthJobdescriptionshared withall providersCM AnalysisincludestreatmentplanassessmentIW follow-up within2 days ofoffice visitFunctionalimprovementdocumentedODGbenchmarksreferencedPT/OTupdatesevery 14daysBehavioralHealth AlertproperlydocumentedTreatmentrequestsproperlyfacilitatedSpecialHandlingInstructionsfollowedImpact ofworry onrecoverydocumentedTemplatescompletedper PMAstandardsPOAaddressespsychosocialbarriersHealthwiseeducationdocumentedIncludeCPT codesforprocedures,Share jobdescriptionwith ALLproviders,Propertemplateformatused (!bha)Documentemployeraccommodationstatus,ConcentrationdifficultiesnotedPOAaddressesmedicationmanagementProviderfollow-upwithin 1 dayof office visitConfoundingfactorsupdatedOngoing IWeducationdocumentedSymptomprogressionmonitoringplandocumentedInitialadjustercontactwithin 1business dayUse onlyapprovedabbreviations,TransitionaldutyoptionsexploredEmployercollaborationfor RTWdocumentedMonthly IWcontactdocumentedLASERtechniquesdocumentedwhenappropriateAlertaddressedwithin 24hoursPsychosocialbarriers torecoveryidentifiedLASERtechniqueused withresistant IWSpecificactions withexact datesdocumentedRTWnegotiationbased onODGguidelinesIncludeICD-10codes withdiagnosis,Documentmedicationcompliance,ActivelisteningtechniquesdocumentedICD-10 codeincludedwithdiagnosisIW/Provider/Employercontact within 2business daysNetworkprovidersproperlydocumentedInitialAssessmentcompletedwithin 5business daysAdjusterupdate within1 day ofappointmentfindingsConcisedescriptionof behavioralissue (1-2lines)MotivationalinterviewingtechniquedocumentedComorbiditiesproperlydocumentedHealthwiseresourcesprovided forbehavioralhealthJobdescriptionshared withall providersCM AnalysisincludestreatmentplanassessmentIW follow-up within2 days ofoffice visitFunctionalimprovementdocumentedODGbenchmarksreferencedPT/OTupdatesevery 14daysBehavioralHealth AlertproperlydocumentedTreatmentrequestsproperlyfacilitatedSpecialHandlingInstructionsfollowedImpact ofworry onrecoverydocumentedTemplatescompletedper PMAstandardsPOAaddressespsychosocialbarriersHealthwiseeducationdocumentedIncludeCPT codesforprocedures,Share jobdescriptionwith ALLproviders,Propertemplateformatused (!bha)Documentemployeraccommodationstatus,ConcentrationdifficultiesnotedPOAaddressesmedicationmanagementProviderfollow-upwithin 1 dayof office visitConfoundingfactorsupdatedOngoing IWeducationdocumentedSymptomprogressionmonitoringplandocumentedInitialadjustercontactwithin 1business day

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