Below you’ll find a list of resources to help make your first visit to our office a breeze. Please print out and complete the forms below and bring them with you to your initial appointment. If you have any questions regarding your upcoming appointment, please call us at 855-286-2020
Appointment Instructions
Click on the appropriate link below to view/print your appointment instructions.
- General Appointments
- Contact Lens Appointment
- Lasik Appointments
- Retina Appointments with Dr. Ying
- No Show & Late Cancellation Policy
- Patient Code of Conduct
No-Insurance Appointment Cancellation Policy
Effective April 28, 2025
At Longwood Eye & LASIK, we value your time and strive to maintain an efficient and fair schedule for all patients. To ensure that appointments are confirmed and prepared in advance, we require insurance or payment information ahead of your visit.
🕒 What You Need to Know:
- If we do not have your insurance information or a self-pay agreement on file, our Eligibility Team will try to contact you 3 business days prior to your scheduled appointment.
- You must respond by 4:00 PM 2 business days before your appointment.
💡 Example:
If your appointment is onThursday, we will reach out to you byMonday, and you must respondno later than Tuesday at 4:00 PM.
✅ What You Need to Do:
Please provide:
- Your insurance details, or
- Written/verbal confirmation that you will proceed as a self-pay patient
Failure to provide this information in time will result in yourappointment being canceled.
📞 Need Help?
If you have questions or need assistance, please contact ourEligibility Teamat:
📱 413-286-2020 or 978-396-2020
Important Notice for MassHealth Patients
Starting August 1, 2025
MassHealth is reinstatingreferral requirementsfor certain plans, including:
- Medicaid PCC Plan (Primary Care Clinician Plan)
- Medicaid CCC Plan (Community Care Cooperative)
- Medicaid Revere (Revere Health Choice)
What this means for you:
✅ If you have one of these plans, youmust have a referral from your primary care provider (PCP) before your visit.
✅ Your PCP can only give a referral if you have seen themwithin the past year.
✅ We must receive your referral at least one week before your appointmentor your appointment may be canceled.
✅ We will NOT make a new appointment for you unless you have a PCP that you have seen within the past year.
Questions?
Please ask a staff member or call us at 413-286-2020 or 978-396-2020, extension 484.
Forms
Patient Education – Eye Conditions
To learn about eye conditions, click here.
Insurances Accepted
To learn about the Insurance Plans we accept, click here.
Financing
To learn about all of the financing options available, click here.
Patient Portal
Log in to our Patient Portal here.
Out Of Network Disclosure
Disclosure Notice Summarizing NSA Protections
Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care—like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.