The Psychology of hen Congress delayed the implementation of ICD- 10 in 2014, people had divergent responses. Whether you breathed a huge sigh of relief or vented frustration at the delay, your actions have since likely coalesced into the same result: inaction. Several delays came before this one, and it is understandable that some providers and billing companies are hesitant to invest additional resources at this time. However, as Benjamin Franklin stated, “By failing to prepare, you are preparing to fail.” Without a crystal ball, one can only rely on known facts regarding the implementation date. As I write this, the Centers for Medicare & Medicaid Services (CMS) states there will be no further delays and the implementation date will be October 1, 2015. CMS scheduled a national testing week in November 2014 for trading partners, and more testing is scheduled for March and June 2015. Right now it appears the slated implementation date may stand. Most likely there are still many companies saying, “I’ve heard those words before so I’m not spending additional resources until I must!” But we are in the business of serving our clients! Taking no action may put your clients at risk, which in turn will be detrimental FEATURE STORY THE JOURNAL OF THE HEALTHCARE BILLING AND MANAGEMENT ASSOCIATION 23 to your own viability. Psychologists explain whenever we are confronted with lifechanging events over which we have no control, our first response is denial. Coders, managers, and administrators have spent years utilizing, reporting on, and memorizing ICD-9 codes. For many coders, their business self-worth is largely based on how well they code. On one single day, their lives are going to change. Shock and denial are significant psychological forces. Anger is the next emotional response in the continuum, a response that needs no explanation. As anger subsides, it is replaced with feelings of helplessness and vulnerability, which contribute to a state of mild protracted depression. This is accented by the eventual acceptance of the reality of ICD-10. This, in turn, elicits a strong need to regain control. Taking action replaces helplessness, vulnerability, and depression with feelings of achievement and conquest. Only when one reaches the final stage of acceptance is there a psychological need to take action. In all other stages, inaction dominates in the form of denial and depression. A state of denial dictates that no action, regardless of how easy or simple it may be, is to be performed. To do so would require one to abandon the denial state and admit acceptance of the reality of ICD-10. The state of denial may be so strong that many people will simply avoid any discussion or action concerning ICD-10 preparation. Ask yourself: What psychological state best describes your present level of ICD-10 preparation? Have you started tackling this project? To delay simply reinforces the feelings of helplessness and vulnerability, creating a self-perpetuating cycle. You owe it to yourself, your employees, and your clients to take action. To break the cycle, you must remove any hint of denial and begin by taking one step at a time. As HBMA members, we have W Taking no action may put your clients at risk, which in turn will be detrimental to your own viability. HOW TO MOVE FROM DENIAL TO ACTION By Dorothy Henslee, CHBME, CPC, RCC
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