Your First Visit
Dr. Maisel would like to take this opportunity to welcome you to the Retina Group of New York. Please click on the name of the following forms, print them, complete them at home, and bring them to the office. It will save time if you bring this completed form when you come to our office for your visit. You can expect to be in the office for approximately 2 hours, depending on your eye problem and the type of testing and treatment required. There is Handicapped parking on the South side of the Hicksville building or the Northeast parking lot by the Chase Bank in Islandia for your convenience.
You will need to come with a driver since your eyes will be dilated for several hours. Make sure you fill out both sides of the application, including the names and addresses of your primary care and referring doctors and the amounts and types of medications you take. Also, please remember to bring your glasses.
We participate in a number of insurance plans, including Medicare, but you will be responsible for any deductible or co-payment. We would be happy to assist you with any paperwork if necessary.
IF YOUR INSURANCE COMPANY REQUIRES PRIOR APPROVAL OR A REFERRAL AUTHORIZATION, PLEASE BE SURE THAT WE RECEIVE IT BEFORE YOUR VISIT.
If you have any questions prior to your appointment, please do not hesitate to call us.
Patient Forms
Instructions: Please click below to download a form, then print and return by mail, fax to (516)-939-2510, or bring to our office.
Due to HIPAA regulations, these forms cannot be emailed to us or submitted online from the website.
Languages Spoken (Please request translator when making appointment)
● English.
● Spanish.
● Italian.
● Hindi.
● Urdu.
● Russian.
● Most other languages with translator.
The Retina Group of New York is used to handling urgent cases referred from other ophthalmologists such as trauma, complications of cataract surgery and retinal detachments. We are delighted to provide second opinions in complicated cases. We are available 7x24. We frequently work with other retinal physicians in different parts of the country, especially with our snow bird patients.
Insurance Plan Participation
The Retina Group of New York Participates in the following insurance plans. These may be updated frequently. You may need authorization and/or referral for some plans. Call the office to verify participation with your insurance if not listed here for other plans.
● AARP.● Aetna.● Age-Well.● BCBS.● Care Connect North Shore/LIJ.● Cigna.● EXCEPT EXCHANGE PLAN.● GHI.● Healthcare Partners.
● HIP.● Humana.● Magnacare.● Medicare.● Meritain.● Multiplan.● National Association of Letter Carriers.● Oxford.● Oxford Liberty.
● Quality Health Plans of NY.● SEIU 1199.● Tricare.● UMR.● United Healthcare.● US Family Health Plan.● Vytra.
American Diabetes Association
stepout.diabetes.org / www.diabetes.org
The American Diabetes Association is the nation's leading 501(C)3 nonprofit charity providing diabetes research, information and advocacy. Step Out Walk to Stop Diabetes takes place across the country and is the premiere walk event supporting all people living with diabetes. It’s your turn to join other passionate people and register today!
JDRF
JDRF is the leading global organization funding type 1 diabetes (T1D) research. Our strength lies in our exclusive focus and singular influence on the worldwide effort to end T1D.Vision: A world without type 1 diabetesMission: Accelerating life-changing breakthroughs to cure, prevent and treat T1D and its complications
Foundation Fighting Blindness
The urgent mission of the Foundation Fighting Blindness is to drive the research that will provide preventions, treatments and cures for people affected by retinitis pigmentosa, age-related macular degeneration, Usher syndrome and the entire spectrum of retinal diseases.
"The word 'doctor' is derived from the Latin word meaning 'to teach.' We take our educational responsibilities seriously and strive to educate patients and their families about their eye conditions. We also contribute to the education of ophthalmologists and other retina specialists through lectures, meetings, and medical advisory boards."
James M. Maisel, MD, FAAO