Strong denial is a forceful, often vehement, refusal to accept an obvious truth or reality, acting as a psychological defense mechanism to protect oneself from painful emotions like fear, guilt, or shame, but it can involve behaviors like making excuses, blaming others, or outright refusing to discuss the issue despite evidence. While it offers temporary relief, it's an irrational coping strategy that prevents addressing real problems, leading to potential harm in the long term, notes Psychology Today and Verywell Mind.
In my Atlanta counseling and psychotherapy practice I talk with clients about the four types of denial of responsibility, which are denial of fact, impact, accountability and hope. This brief article describes how to recognize and respond to them.
Denial is sometimes seen more often with certain types of mental health conditions. People who have substance abuse disorder, alcohol use disorder, and narcissistic personality disorder, for example, may use this defense mechanism more often to avoid facing the reality of their condition.
Hard denials are final and typically non-recoverable. They often stem from issues like a lack of medical necessity or services not covered by the payer. These denials usually require a formal appeal process. If unsuccessful, complex denials tend to result in lost revenue.
Denial is a form of psychological protection. We lie to ourselves to protect ourselves from certain truths yet ironically the things we deny cause us much more pain and suffering in the long run. Conversely, facing certain realities also causes us pain and denial yet helps us to avoid feeling badly.
Denial is often rooted in the desire to protect oneself from anxiety and distress. It can occur in response to a variety of situations, including: Stress: Avoiding the reality of a stressful situation to prevent feeling overwhelmed. Fear: Fearing the consequences of acknowledging a problem, leading to avoidance.
Myth: Most denials are caused by fraud.
The reality is that most denials stem from documentation gaps, missing information, or coding errors. These preventable issues create avoidable backlogs that overwhelm both provider offices and payer teams.
Spotting behavior patterns that suggest denial
Denials are mainly classified into two types: soft and hard. Soft denials have minimum technical errors and are easy to correct. Hard denials are related to clinical issues that are difficult to appeal.
Denial code 4 is used when the procedure code is inconsistent with the modifier that was used. This means that the modifier attached to the procedure code does not match the requirements or guidelines set by the payer.
To be clear, denial is not a mental disorder; however, people often mistakenly believe that anosognosia is denial.
You can only be given medication after an initial 3-month period in either of the following situations: You consent to taking the medication. A SOAD confirms that you lack capacity. You haven't given consent, but a SOAD confirms that this treatment is appropriate to be given.
Borderline Personality Disorder is frequently cited as one of the hardest mental disorders to live with, not because people with BPD are difficult, but because the disorder itself is emotionally intense and relentless. It affects the way a person sees themselves and others. Feelings come on fast and strong.
“Delay is the deadliest form of denial,” said historian C. Northcote Parkinson.
Denial Code CO-97 is used in medical billing to indicate that a claim has been denied because the billed service is considered part of another service that has already been processed.
The five stages – denial, anger, bargaining, depression and acceptance – are often talked about as if they happen in order, moving from one stage to the other. You might hear people say things like 'Oh I've moved on from denial and now I think I'm entering the angry stage'.
Claim not filed on time (aka: Timely Filing)
If a proper claim is submitted, but it's not within the timing window, it may result in a denial. It is recommended that you check with your Payers regarding their filing deadlines.
1. Soft Denial: A temporary or interim denial that may be paid if the practice takes corrective action; no appeal is needed. 2. Hard Denial: A denial resulting in lost or written-off revenue; an appeal is required.
Big takeaway: A rejection stops a claim before it's processed – or adjudicated – by the payer. Denials happen after adjudication. Knowing which one you're dealing with determines what you can do next. Rejections and denials are two of the most common – and misunderstood – claim outcomes.
Symptoms of stress
The denial stage can be longer for those suffering a loss related to a traumatic event. Some people start to feel better in weeks or months, while the grief process can take years for others. The denial stage has no designated time frame. It varies between individuals and their ability to adapt and cope.
In this must-read book, Carroll introduces five distinct stages of love, including the Merge, Doubt and Denial, Disillusionment, Decision, and Wholehearted Love. You may already be aware of the many challenges that couples face as they navigate through different stages of their relationship.
Denial can be adaptive, helping individuals cope with overwhelming situations, such as receiving a terminal diagnosis, or maladaptive, leading to poor decision-making and avoidance of necessary actions, like seeking medical treatment for an illness or addressing substance abuse issues.
Practice Mindfulness: Mindfulness techniques, such as meditation and deep breathing, can help you stay present and grounded. They enable you to observe your thoughts and emotions without judgment, making it easier to confront denial.
Specifically, MAD proposes that the memory deterioration effect of denial is caused by the fact that the act of denial monopolizes cognitive resources. Because of this, participants are less likely to rehearse what they have denied, leading to forgetting effects.