Insurance Information

• I am an out-of-network provider for most insurances but if your insurance card says “POS” or “PPO”, your plan may reimburse some cost of the session, sometimes 70% - 80%.
• Please contact your insurance company to see whether you have out-of-network coverage before we meet at our first session. Ask whether and how much the insurance company will reimburse for “procedure codes 90791 and 90834 for out-of-network providers”.
• Payment is requested when services are rendered. I will provide you a receipt to submit to your insurance company for reimbursement.
• I accept checks, cash, credit cards, Venmo and other forms of payment.
• I offer a limited number of clients a sliding scale based on financial need.
• Initial consultations are billed at the regular session fee.
• Please provide 48 hours’ notice for cancellations; otherwise, a missed appointment will be billed at the regular session fee.

Documents For Your First Appointment

If you prefer, bring the following forms to our first session or I can provide them when you arrive:

• New Patient Intake Form
• HIPPA Privacy Disclosure Acknowledgement
• Treatment and Fee Agreement
• Sleep Log (if meeting for help with sleep)

Email or call to get started. I try to respond within 24 hours.

Office: 65 Rice Road Wayland, MA 01778
Phone: 508-655-8683
Email: drdenaray@gmail.com
Website: www.drdenaray.com