POAaddressespsychosocialbarriersSpecificactions withexact datesdocumentedActivelisteningtechniquesdocumentedConcentrationdifficultiesnotedProviderfollow-upwithin 1 dayof office visitTransitionaldutyoptionsexploredEmployercollaborationfor RTWdocumentedOngoing IWeducationdocumentedConcisedescriptionof behavioralissue (1-2lines)Jobdescriptionshared withall providersComorbiditiesproperlydocumentedSpecialHandlingInstructionsfollowedLASERtechniquesdocumentedwhenappropriateAdjusterupdate within1 day ofappointmentfindingsODGbenchmarksreferencedCM AnalysisincludestreatmentplanassessmentPT/OTupdatesevery 14daysICD-10 codeincludedwithdiagnosisIncludeICD-10codes withdiagnosis,InitialAssessmentcompletedwithin 5business daysSymptomprogressionmonitoringplandocumentedMotivationalinterviewingtechniquedocumentedIW follow-up within2 days ofoffice visitTreatmentrequestsproperlyfacilitatedInitialadjustercontactwithin 1business dayBehavioralHealth AlertproperlydocumentedMonthly IWcontactdocumentedDocumentmedicationcompliance,LASERtechniqueused withresistant IWNetworkprovidersproperlydocumentedConfoundingfactorsupdatedTemplatescompletedper PMAstandardsPOAaddressesmedicationmanagementUse onlyapprovedabbreviations,HealthwiseeducationdocumentedDocumentemployeraccommodationstatus,Propertemplateformatused (!bha)RTWnegotiationbased onODGguidelinesImpact ofworry onrecoverydocumentedFunctionalimprovementdocumentedIW/Provider/Employercontact within 2business daysAlertaddressedwithin 24hoursShare jobdescriptionwith ALLproviders,Healthwiseresourcesprovided forbehavioralhealthPsychosocialbarriers torecoveryidentifiedIncludeCPT codesforprocedures,POAaddressespsychosocialbarriersSpecificactions withexact datesdocumentedActivelisteningtechniquesdocumentedConcentrationdifficultiesnotedProviderfollow-upwithin 1 dayof office visitTransitionaldutyoptionsexploredEmployercollaborationfor RTWdocumentedOngoing IWeducationdocumentedConcisedescriptionof behavioralissue (1-2lines)Jobdescriptionshared withall providersComorbiditiesproperlydocumentedSpecialHandlingInstructionsfollowedLASERtechniquesdocumentedwhenappropriateAdjusterupdate within1 day ofappointmentfindingsODGbenchmarksreferencedCM AnalysisincludestreatmentplanassessmentPT/OTupdatesevery 14daysICD-10 codeincludedwithdiagnosisIncludeICD-10codes withdiagnosis,InitialAssessmentcompletedwithin 5business daysSymptomprogressionmonitoringplandocumentedMotivationalinterviewingtechniquedocumentedIW follow-up within2 days ofoffice visitTreatmentrequestsproperlyfacilitatedInitialadjustercontactwithin 1business dayBehavioralHealth AlertproperlydocumentedMonthly IWcontactdocumentedDocumentmedicationcompliance,LASERtechniqueused withresistant IWNetworkprovidersproperlydocumentedConfoundingfactorsupdatedTemplatescompletedper PMAstandardsPOAaddressesmedicationmanagementUse onlyapprovedabbreviations,HealthwiseeducationdocumentedDocumentemployeraccommodationstatus,Propertemplateformatused (!bha)RTWnegotiationbased onODGguidelinesImpact ofworry onrecoverydocumentedFunctionalimprovementdocumentedIW/Provider/Employercontact within 2business daysAlertaddressedwithin 24hoursShare jobdescriptionwith ALLproviders,Healthwiseresourcesprovided forbehavioralhealthPsychosocialbarriers torecoveryidentifiedIncludeCPT codesforprocedures,

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