FEES AND INSURANCE
The fees we charge at CAPS go into a university account to help operate the center. There is no charge for the BSC (Brief Screening and Consultation) that occurs prior to starting therapy. There is no charge for groups or case management. Fees are due at the time of service. We accept cash, checks, or credit cards (Visa, Master Card, Discover, American Express)*. If you miss a therapy or psychiatry appointment without giving 48 hours’ notice, we will charge you a missed session fee of $20.00. Insurance companies will not pay such charges. If you incur a balance on your account, we may suspend therapy until you pay the amount due or work out a payment plan with us. For any questions about fees and charges, including if you believe you cannot afford the charges for missed sessions, please contact the Program Manager at 556-0648.
*If using a credit card to pay for services, the transaction will appear on the monthly credit card statement as UNIV CINTI CAPS.
|Service||Time||Total Charge||Co-pay if using UC Student Health Insurance|
|Brief Screening and Consultation (BSC)||15-20 min||no charge||0|
|Intake Interview||1 hr||$60
|Individual Therapy||1 hr||$60
|Psychiatric Evaluation||1 hr||$60
|Psychiatric Medication Management||30 min||$60
|Group Screening||30 min||no charge||0|
|Group Therapy||1.5 hrs||no charge||0|
|Case Management||Varies||no charge||0|
|Substance Use Psycho-Educational Screening||1.5 hr X 2||$155||$155 – not covered by insurance|
|Missed Session Fee (< 48 hrs notice)||20||0|
Students with UC Student Health Insurance
The majority of our clients have Student Health Insurance through the university. An initial deductible is waived by the insurance company for this setting. We bill the insurance company for their portion of the charge (80%). You are responsible for the co-pay amounts listed above. Please note that substance-related diagnoses are reimbursed at a lower rate, 50%, so your co-pay would be $30.
Students with Other Insurance Plans
If you have other coverage, you can call the number on your insurance card for mental health benefit information. Always be sure to specify that you are calling about mental health benefits, as the terms and the deductible may be different from those for medical benefits.
You are required to use your mental health coverage if you are on an active policy.
Your plan may not cover services at CAPS because we are not in its health maintenance organization (HMO) or preferred providers (PPO) network. Alternatively, it may cover services from CAPS at a much lower rate than professionals in its network, and it may require that you be pre-certified for services by the company or referred by a physician to start therapy. We do not have a limit on the number of sessions you can receive, but your insurance company may have limits on the number they will cover. Plans may limit services to 20, 10, or even fewer sessions a year. They may also have pre-existing condition clauses. We will follow the rules of your insurance company in charging you a deductible and co-pay. You may find, however, that it is considerably more affordable to find a mental health provider through your insurance company. If you have in-network mental health coverage, but choose not to use it, you are responsible to pay the entire session fee out of your own funds.
Your insurance may cover our fees. However, many insurance plans have “deductibles”—an amount that must be paid before the insurance starts to provide payments. Deductibles apply to each policy year, so on your policy effective date you must again pay your deductible amount before insurance coverage pays for some of the charge.They also have co-payments that the individual receiving services must pay.
A further issue may be a “pre-existing condition” clause. For example, if a person has seen a health professional for a condition in a period (often 12 months) before a new policy starts, the policy may not cover treatment for that condition for some time (again, often 12 months). Moreover, many policies provide different benefits if you see a professional in a network they have established versus seeing someone not in the network. Both the number of sessions covered and the amount of your co-payment may be different.
Plans vary widely.You will not know for sure what your benefits are until you read the plan’s materials and call the insurance company.Your plan may distinguish services within a network of providers who have an arrangement with them and those outside of the network.
CAPS is not in any networks except the Student Health Insurance plan.Therefore, it may cost you less to see a mental health professional through your insurance plan. For example, your insurance may expect you to pay $500 as a deductible before they pay anything if you see us at CAPS ; but they may have no deductible if you see one of the professionals in their network. Your co-pay if you see us may be 50% for each session, but only $10 if you are seen in network.
It is very important that you learn about your insurance policy to understand how it actually works. You can get information from brochures the company provides and by calling the number on your insurance card for mental health services. When you know what benefits you have, you can make a more informed decision about where to get services—for example, from CAPS or from a private practitioner or other agency. Although there are also other considerations besides the financial ones, the issue of affordability is realistic. We have a Health Insurance Worksheet that can help you communicate with your insurance company and determine your coverage.
Students with No Mental Health Coverage
If you have no mental health coverage of any kind, you are responsible for the entire fee (see fee schedule above). If you can demonstrate financial hardship, you may be eligible for a reduced fee of $20 per session.
Missed Session Fee
When a client cancels late or does not show for an appointment, clinicians often do not have the opportunity to schedule another client who needs our services.
A $20 missed session fee is assessed for the following: late cancellation (less than 48 hours) and no show (fail to show for your appointment).
This $20 fee is applicable for the following services/appointments: intake interview, psychiatric intake interview, individual therapy, medication management, psychiatric treatment consultation, group screenings, and case management. Group therapy is exempt from the fee.
All fees are waived for the following: students with Medicaid or Medicare, students who are current recipients of a Cincinnati Pride Grant, and students who are veterans. Verification will be required. However, the $20 missed session fee for no shows and late cancellations (less than 48 business hours’ notice) will apply.
When you come to CAPS for your intake appointment, we give you a condensed version (Fee Agreement) of all this information before your actual interview; you are required to read and initial statements related to fees and insurance. We also request your insurance card to make a copy so we can contact your plan to verify your coverage. Our administrative staff will discuss your coverage and determine your payments. If we need to contact your insurance company, it may take longer, but you will be contacted soon with your payment information. You are required to pay the full fee amount until your coverage is verified and we know the amount of your co-pay.
If you have questions about Student Health Insurance, you can check online at www.uc.edu/uhs/studenthealthinsurance or call the insurance office at 556-6868.