ICD-10 Compliance Coaching Newsletter – July 7 2015

see this issue’s email notice as a web page

ICD-10 Fast-Track Compliance by Mike Magliaro

This Week’s Major Topics

  • There no time left now to adopt a “Best Practices” Plan
  • “Survival Mode” = Use Weekly Checklists to Survive
  • Checklists also validate existing plans, processes

Your Backup Plan Might Now Be Your Best Plan “A”

Click the image to see the web version

Click the image to see the web version

This past Monday, July 6, 2015, the American Medical Association (AMA) and the Centers for Medicare and Medicaid Services (CMS) actually did us all a favor when they declared a plan to allow for some “transition” period, at least for physicians, related to the implementation of the ICD-10 system.

What favor? They removed any doubt that ICD-10 is now in fact happening, as of October 1, 2015.

To that end, then… if your facility or practice was waiting to see what would really happen before they invest heavily in making the transition… well, that just changed everything. Whatever your “backup plan” was for making the change at the last minute, that just became your Plan A for Implementation of ICD-10.

Those provider and payer organizations having essentially completed a Best Practices ICD-10 Compliance Process, INCLUDING WORKING TOGETHER are in good shape – from interaction with literally hundreds these organizations, approximately 50 percent of all of healthcare organizations will be ready with their PLAN A. That means roughly 50 percent will be scrambling and ACTIVATING PLAN B. Plan B would normally be considered the “Contingency or Backup Plan”, when Plan A would normally be considered the “Primary Plan”, and was Implemented and did not work!

Realistically, many no longer have time for a Best Practices Plan A. This is not the end of the world – remember October 1 is just the START. PLAN B enables SURVIVAL, then Best Practices.

For those in the PLAN B situation, I will publish a set of weekly checklists, in this Weekly Countdown Newsletter (my time permitting) for those “starting from scratch” with 12 weeks to go (it will also serve as a helpful check-and-balance for those in good shape with PLAN A). Before getting into this week’s content, I would urge those in larger organizations in the PLAN B Category to get help if you can, managing all of the moving parts and getting physician buy-in – you don’t have the time for climbing the learning curve.


Key for the Week:
Week 12 Baseline Readiness Assessment Checklist

Click the image to download a PDF of the  Week 12 Checklist

Click the image to download a PDF of the
Week 12 Checklist

This is Consulting and Management 101 – You should do a Gap/Readiness Assessment to get a baseline as to where you are NOW with your Business/Trading Partners (including Commercial Payers), Processes, Technology and Workforce Members. This week complete the Baseline Readiness Assessment Checklist – answer it in detail and answer it honestly!

This is just another major reason I now offer Weekly One-hour Small Group Coaching Sessions for ICD-10 Transition, Two-hour Small Group Compliance Readiness Assessment Sessions, and Four-Hour Small Group Compliance Walk-Thru & Workshops.

To make sure you can get individual attention, we’ve limited the group sizes, so be sure to sign up soon, to save your seat!

Complete details and links to save your seat are here.

Coming Soon in Our Coaching Sessions:

The feedback from our attendees prompted us to prepare even more detailed coaching for dealing with all the payers, so we will add some much needed focus on that in our future sessions.


It’s NEVER TOO LATE to get started… New Coaching Sessions are offered every week.

In the upcoming Coaching Sessions and Workshops then, I will be talking about and answering questions on:

  • The Real State of Payer ICD-10 Readiness;
  • The Three Major Strategies Payers Are Using to Process Claims Post-October 1, 2015-and It Probably Isn’t What You Would like to Think; and
  • How to Incorporate Payers in Your ICD 10 Planning and How You Should Be Interacting with Them

Watch for next week’s Newsletter, and Good Luck with all of your planning!


Weeks Remaining Until ICD-10 Goes LIVE

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Resistance to Change Can Be Your Ally

by Ernie de los Santos

Overcoming Resistance to Change... Can you do that?

Overcoming Resistance to Change… Can you do that? CLICK THE IMAGE if you can watch a short video on YouTube about this topic – it’s about 6 minutes long…

You’ve either said this or heard it said about your organization, whenever someone is trying to change the behavior of individuals or groups: our plan didn’t work because people resist change.

People resist change. Everyone knows it, right?

It’s true, people are resistant to change. But then again, sometimes, they DO change, they even change their behavior. So how does that happen? How do some changes happen, while others are so flatly resisted and refused?

Let’s consider a change that I think you might readily accept. Think about this: if someone offered you $10 Million, totally legal, tax free, no strings attached, would you take it? I would! But if you take that money, would it change your life? Sure it would. So why would anyone take the money, if it would change their life, and as we all know, people resist change? Why would we NOT resist that change?

What’s In It For Me?

Doctors are NOT the only ones who do this... You and I do it too!

Doctors and Nurses and Other Staff are NOT the only ones who do this… You and I do it too!

The reasons boil down to “what’s in it for me?” but it’s a little more complicated that just the one question.

Here’s how that looks…

IF         you see that this change is “good” for you…

AND     it’s safe to do…

AND     it doesn’t “cost” too much to do…

AND      you don’t have to give up much…

THEN   you’ll accept the change!

While that may seem like a relatively simple explanation, what goes on in the mind of the person making the change is a little more involved. But fortunately, those processes – the things that a person thinks about when evaluating a proposed “change” – are pretty consistent. A strategy exists that can be used to show people the “what’s in it for me” answers.

What I am about to show you is how to
make “Resistance to Change” your best ally.

Years of Research Reveals How to “Use” Resistance to Change

Resistance to change is really part of human nature, but you can learn to use it to your advantage.

Resistance to change is really part of human nature, but you can learn to use it to your advantage.

Resistance to Change is known to have five very recognizable layers, layers of resistance. (And yes, there are studies about all this, I’ll give them to you in another issue.) YOU can use those layers to shape your presentations and design them to move your audience down the path to accepting your project – effectively, getting them to BUY IN to your project – and therefore make it all happen!

Now let’s be real for a moment… there may always be a certain percentage of people who will resist anything you throw at them. Research shows that whenever someone is faced with making a change, they will start to construct arguments against the problem even existing, much less even requiring a change in their behavior. This is human nature. We cannot change human nature. But… we can USE it.

AND… this strategy will work on almost everyone.

Ok, so I couldn't find an image of a curmudgeonly healthcare worker, so I settled for Scrooge. Similar attitude, yes?

So I couldn’t find an image of a curmudgeonly healthcare worker, so I settled for Scrooge. Similar attitude, don’t you think? Maybe they’d get visited by the Ghost of Denials Past?

Ok, I say almost, because in some cases – and you can probably name the people I’m talking about in your own organization – no change is acceptable, period. There are those who are simply too stubborn to change, at all, for any reason. For them, there is no solution.

Hopefully, and I mean this in the best way possible, they will disappear from your organization – for whatever reason… retirement, old age (sorry, but it’s true), lots of reasons, lots of things you can hope for pray for expect. Anyway, there’s not much you can do with those folks, so let’s move on, and concentrate on everyone else, because you CAN have an effect on them.

Now let me tell you about those five layers of resistance.

Recognizing the Five Layers

If you’ve ever done selling or project management, you’ll probably recognize these “layers” of resistance, as I go through each one, below. They are not NEW, but I’m sure you have not thought of them in this way, before. We’ve all run into them, one way or another, in either our business life and/or our personal life.

Some things that come in "layers" are really nice.

Some things that come in “layers” are really nice.

I’ll describe them briefly this week, and in future issues, I’ll tell you about how to overcome them, how to answer questions from people at your presentation in a way that makes them solve problems for you, how to plan all this ahead of time, and sources of further reading. (I wish this was all thought of by little old me, but no joy… I stand on the shoulders of Giants…)

Here are the Five Layers, in the order in which they typically are found or arise:

1 – Disagreement on what the problem IS.

Think about it. Do your listeners agree with you about what the problem really is to begin with? Do they even agree with you that there even IS a problem? If not, you’re already dead in the water and you haven’t even proposed a solution yet, so you have to address this FIRST.

2 – Disagreement on how to solve the problem.

Now that they recognize and agree on what the problem is, they might have a completely different direction in mind for how to solve the agreed upon problem. And their own direction/idea may be completely in conflict with your idea, or at least cannot also be implemented at the same time. And whose idea will they more likely get behind – yours or theirs?

3 – Disagreement that the solution will actually solve the problem.

Just because they agree that you can identify the problem and what a solution would accomplish, are they convinced that your solution will actually fix the problem? Or will it only fix part of the problem? How can you show that it will fix the problem completely or at least enough to make all this effort worthwhile?

4 – The solution is going to create more problems, even if it solves some.

What about unintended consequences, see or unseen? Will your solution cause more or new problems? How will your solution address these and future problems that we can envision to arrive? Your solution just might create other problems – but if so, you’re going to have to either solve them or show that they are not nearly as big a problem as the one(s) you are solving.

5 – Disbelief that the solution can even be implemented, anyway.

It all sounds good, but is what you are suggesting even remotely possible? Are you suggesting something that seems wholly impossible to implement? It doesn’t matter how good the idea is, if you can’t make it happen.

Once Peeled, the Best Part is Revealed…

I can't resist the pun:  Peeling the layers back is fruitful!

I can’t resist the pun: Peeling the layers back is fruitful!

Knowing what the layers are, why they are there, and how they progress, you can plan your presentation (rather like planning a sales pitch), to overcome each layer.

Next week, I’ll start to go over how to deal with each of the five layers, and make them work FOR you.

Meanwhile… don’t miss the great Coaching being offered for your implementation plans.

You can learn directly from someone who has been coaching ICD-10 compliance for eight years, and recently has been coaching about 200 hospitals, by visiting this page to find out all you need to know and to save your seat in these limited availability sessions.

The ICD-10 Compliance Coaching Newsletter is provided free of charge by

Appeal Academy & Magliaro Advisory Services

appealacademy.com | michaelmagliaro.com

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