Jobdescriptionshared withall providersInitialadjustercontactwithin 1business dayTransitionaldutyoptionsexploredConcentrationdifficultiesnotedFunctionalimprovementdocumentedShare jobdescriptionwith ALLproviders,Monthly IWcontactdocumentedConcisedescriptionof behavioralissue (1-2lines)Alertaddressedwithin 24hoursPOAaddressesmedicationmanagementODGbenchmarksreferencedHealthwiseeducationdocumentedCM AnalysisincludestreatmentplanassessmentComorbiditiesproperlydocumentedSymptomprogressionmonitoringplandocumentedUse onlyapprovedabbreviations,LASERtechniquesdocumentedwhenappropriateDocumentemployeraccommodationstatus,RTWnegotiationbased onODGguidelinesAdjusterupdate within1 day ofappointmentfindingsSpecificactions withexact datesdocumentedPOAaddressespsychosocialbarriersIncludeCPT codesforprocedures,Propertemplateformatused (!bha)Documentmedicationcompliance,SpecialHandlingInstructionsfollowedNetworkprovidersproperlydocumentedIncludeICD-10codes withdiagnosis,PT/OTupdatesevery 14daysIW follow-up within2 days ofoffice visitBehavioralHealth AlertproperlydocumentedOngoing IWeducationdocumentedProviderfollow-upwithin 1 dayof office visitConfoundingfactorsupdatedPsychosocialbarriers torecoveryidentifiedTemplatescompletedper PMAstandardsLASERtechniqueused withresistant IWTreatmentrequestsproperlyfacilitatedHealthwiseresourcesprovided forbehavioralhealthInitialAssessmentcompletedwithin 5business daysMotivationalinterviewingtechniquedocumentedActivelisteningtechniquesdocumentedEmployercollaborationfor RTWdocumentedICD-10 codeincludedwithdiagnosisIW/Provider/Employercontact within 2business daysImpact ofworry onrecoverydocumentedJobdescriptionshared withall providersInitialadjustercontactwithin 1business dayTransitionaldutyoptionsexploredConcentrationdifficultiesnotedFunctionalimprovementdocumentedShare jobdescriptionwith ALLproviders,Monthly IWcontactdocumentedConcisedescriptionof behavioralissue (1-2lines)Alertaddressedwithin 24hoursPOAaddressesmedicationmanagementODGbenchmarksreferencedHealthwiseeducationdocumentedCM AnalysisincludestreatmentplanassessmentComorbiditiesproperlydocumentedSymptomprogressionmonitoringplandocumentedUse onlyapprovedabbreviations,LASERtechniquesdocumentedwhenappropriateDocumentemployeraccommodationstatus,RTWnegotiationbased onODGguidelinesAdjusterupdate within1 day ofappointmentfindingsSpecificactions withexact datesdocumentedPOAaddressespsychosocialbarriersIncludeCPT codesforprocedures,Propertemplateformatused (!bha)Documentmedicationcompliance,SpecialHandlingInstructionsfollowedNetworkprovidersproperlydocumentedIncludeICD-10codes withdiagnosis,PT/OTupdatesevery 14daysIW follow-up within2 days ofoffice visitBehavioralHealth AlertproperlydocumentedOngoing IWeducationdocumentedProviderfollow-upwithin 1 dayof office visitConfoundingfactorsupdatedPsychosocialbarriers torecoveryidentifiedTemplatescompletedper PMAstandardsLASERtechniqueused withresistant IWTreatmentrequestsproperlyfacilitatedHealthwiseresourcesprovided forbehavioralhealthInitialAssessmentcompletedwithin 5business daysMotivationalinterviewingtechniquedocumentedActivelisteningtechniquesdocumentedEmployercollaborationfor RTWdocumentedICD-10 codeincludedwithdiagnosisIW/Provider/Employercontact within 2business daysImpact ofworry onrecoverydocumented

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