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INSURANCE FAQ

What is a copay? What is coinsurance?  

A copay (or copayment) is an amount determined by your insurance company that you are expected to pay on the day of your service. Coinsurance is similar to a copay in that it is an amount you are expected to pay at the time of your session; however, it is not a set dollar amount. Instead, it is a percentage of the total fee paid by your insurance company for the service you receive. The copay and coinsurance amounts vary by insurance company and by individual policy and are determined by the insurance company, NOT by Clintonville Counseling and Wellness.

What is a deductible?

We utilize a variety of modalities and theories to address our clients' needs and meet you where you are. We do our The health insurance deductible is similar to that on an auto or house insurance policy. It is the amount you pay before insurance begins to pay. A deductible is typically a set dollar amount. The insurance company will begin to pay claims AFTER the full deductible has been paid. For example, if you have a $2,000 deductible, you will be responsible for paying all expenses for services you receive until you have paid $2,000. After you pay the required $2,000, then insurance will begin to pay benefits. You may still have to pay a copay or coinsurance even after the deductible is met, depending on your individual policy.  The deductible is part of the individual's policy and is set when the policy is selected. The deductible amount is NOT set by Clintonville Counseling and Wellness. We do require full payment at the time of service until deductibles are met.

Why must I provide a copay, coinsurance, or meet my deductible? 

Policies often change and many now have copays or deductibles that you may not have in previous years. You may not have had a deductible in the past but your updated policy may now include one.  Clintonville Counseling and Wellness does not set your copay/coinsurance or deductible amounts. These are part of the policy you have chosen with your insurance carrier. If you call your insurance company or check your insurance portal online, they should be able to explain all copays and/or deductibles that exist on your policy. Be sure to ask specifically about your mental health/behavioral health benefits as these may be different from your medical coverage. Their phone number should be on the back of your insurance card.  Although our Client Care Coordinator will provide a courtesy call to your insurance to inquire about your benefits before your first session, it is ultimately your responsibility to understand your mental health benefits and pay required copays/coinsurance at the time of service. 

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