FunctionalimprovementdocumentedTreatmentrequestsproperlyfacilitatedConfoundingfactorsupdatedShare jobdescriptionwith ALLproviders,IncludeICD-10codes withdiagnosis,NetworkprovidersproperlydocumentedICD-10 codeincludedwithdiagnosisLASERtechniqueused withresistant IWEmployercollaborationfor RTWdocumentedRTWnegotiationbased onODGguidelinesConcentrationdifficultiesnotedOngoing IWeducationdocumentedMonthly IWcontactdocumentedSpecialHandlingInstructionsfollowedAdjusterupdate within1 day ofappointmentfindingsUse onlyapprovedabbreviations,Psychosocialbarriers torecoveryidentifiedActivelisteningtechniquesdocumentedCM AnalysisincludestreatmentplanassessmentLASERtechniquesdocumentedwhenappropriateODGbenchmarksreferencedHealthwiseresourcesprovided forbehavioralhealthPT/OTupdatesevery 14daysBehavioralHealth AlertproperlydocumentedProviderfollow-upwithin 1 dayof office visitAlertaddressedwithin 24hoursDocumentmedicationcompliance,Specificactions withexact datesdocumentedComorbiditiesproperlydocumentedInitialadjustercontactwithin 1business dayIW/Provider/Employercontact within 2business daysIW follow-up within2 days ofoffice visitConcisedescriptionof behavioralissue (1-2lines)InitialAssessmentcompletedwithin 5business daysTemplatescompletedper PMAstandardsPOAaddressespsychosocialbarriersMotivationalinterviewingtechniquedocumentedTransitionaldutyoptionsexploredHealthwiseeducationdocumentedPropertemplateformatused (!bha)Documentemployeraccommodationstatus,SymptomprogressionmonitoringplandocumentedIncludeCPT codesforprocedures,Impact ofworry onrecoverydocumentedJobdescriptionshared withall providersPOAaddressesmedicationmanagementFunctionalimprovementdocumentedTreatmentrequestsproperlyfacilitatedConfoundingfactorsupdatedShare jobdescriptionwith ALLproviders,IncludeICD-10codes withdiagnosis,NetworkprovidersproperlydocumentedICD-10 codeincludedwithdiagnosisLASERtechniqueused withresistant IWEmployercollaborationfor RTWdocumentedRTWnegotiationbased onODGguidelinesConcentrationdifficultiesnotedOngoing IWeducationdocumentedMonthly IWcontactdocumentedSpecialHandlingInstructionsfollowedAdjusterupdate within1 day ofappointmentfindingsUse onlyapprovedabbreviations,Psychosocialbarriers torecoveryidentifiedActivelisteningtechniquesdocumentedCM AnalysisincludestreatmentplanassessmentLASERtechniquesdocumentedwhenappropriateODGbenchmarksreferencedHealthwiseresourcesprovided forbehavioralhealthPT/OTupdatesevery 14daysBehavioralHealth AlertproperlydocumentedProviderfollow-upwithin 1 dayof office visitAlertaddressedwithin 24hoursDocumentmedicationcompliance,Specificactions withexact datesdocumentedComorbiditiesproperlydocumentedInitialadjustercontactwithin 1business dayIW/Provider/Employercontact within 2business daysIW follow-up within2 days ofoffice visitConcisedescriptionof behavioralissue (1-2lines)InitialAssessmentcompletedwithin 5business daysTemplatescompletedper PMAstandardsPOAaddressespsychosocialbarriersMotivationalinterviewingtechniquedocumentedTransitionaldutyoptionsexploredHealthwiseeducationdocumentedPropertemplateformatused (!bha)Documentemployeraccommodationstatus,SymptomprogressionmonitoringplandocumentedIncludeCPT codesforprocedures,Impact ofworry onrecoverydocumentedJobdescriptionshared withall providersPOAaddressesmedicationmanagement

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