Share jobdescriptionwith ALLproviders,SpecialHandlingInstructionsfollowedIW follow-up within2 days ofoffice visitTemplatescompletedper PMAstandardsOngoing IWeducationdocumentedDocumentemployeraccommodationstatus,IW/Provider/Employercontact within 2business daysMotivationalinterviewingtechniquedocumentedJobdescriptionshared withall providersInitialadjustercontactwithin 1business dayImpact ofworry onrecoverydocumentedComorbiditiesproperlydocumentedMonthly IWcontactdocumentedConcisedescriptionof behavioralissue (1-2lines)Alertaddressedwithin 24hoursDocumentmedicationcompliance,ActivelisteningtechniquesdocumentedRTWnegotiationbased onODGguidelinesPOAaddressesmedicationmanagementFunctionalimprovementdocumentedEmployercollaborationfor RTWdocumentedPropertemplateformatused (!bha)BehavioralHealth AlertproperlydocumentedUse onlyapprovedabbreviations,ODGbenchmarksreferencedProviderfollow-upwithin 1 dayof office visitLASERtechniqueused withresistant IWHealthwiseeducationdocumentedICD-10 codeincludedwithdiagnosisConcentrationdifficultiesnotedPT/OTupdatesevery 14daysAdjusterupdate within1 day ofappointmentfindingsCM AnalysisincludestreatmentplanassessmentSpecificactions withexact datesdocumentedPsychosocialbarriers torecoveryidentifiedNetworkprovidersproperlydocumentedSymptomprogressionmonitoringplandocumentedHealthwiseresourcesprovided forbehavioralhealthLASERtechniquesdocumentedwhenappropriateIncludeICD-10codes withdiagnosis,IncludeCPT codesforprocedures,ConfoundingfactorsupdatedTreatmentrequestsproperlyfacilitatedTransitionaldutyoptionsexploredPOAaddressespsychosocialbarriersInitialAssessmentcompletedwithin 5business daysShare jobdescriptionwith ALLproviders,SpecialHandlingInstructionsfollowedIW follow-up within2 days ofoffice visitTemplatescompletedper PMAstandardsOngoing IWeducationdocumentedDocumentemployeraccommodationstatus,IW/Provider/Employercontact within 2business daysMotivationalinterviewingtechniquedocumentedJobdescriptionshared withall providersInitialadjustercontactwithin 1business dayImpact ofworry onrecoverydocumentedComorbiditiesproperlydocumentedMonthly IWcontactdocumentedConcisedescriptionof behavioralissue (1-2lines)Alertaddressedwithin 24hoursDocumentmedicationcompliance,ActivelisteningtechniquesdocumentedRTWnegotiationbased onODGguidelinesPOAaddressesmedicationmanagementFunctionalimprovementdocumentedEmployercollaborationfor RTWdocumentedPropertemplateformatused (!bha)BehavioralHealth AlertproperlydocumentedUse onlyapprovedabbreviations,ODGbenchmarksreferencedProviderfollow-upwithin 1 dayof office visitLASERtechniqueused withresistant IWHealthwiseeducationdocumentedICD-10 codeincludedwithdiagnosisConcentrationdifficultiesnotedPT/OTupdatesevery 14daysAdjusterupdate within1 day ofappointmentfindingsCM AnalysisincludestreatmentplanassessmentSpecificactions withexact datesdocumentedPsychosocialbarriers torecoveryidentifiedNetworkprovidersproperlydocumentedSymptomprogressionmonitoringplandocumentedHealthwiseresourcesprovided forbehavioralhealthLASERtechniquesdocumentedwhenappropriateIncludeICD-10codes withdiagnosis,IncludeCPT codesforprocedures,ConfoundingfactorsupdatedTreatmentrequestsproperlyfacilitatedTransitionaldutyoptionsexploredPOAaddressespsychosocialbarriersInitialAssessmentcompletedwithin 5business days

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