At Access Hospital Dayton, we strive to make the referral process as simple as 1-2-3!
Step 1: Determine Clinical Eligibility
- Does the patient require inpatient detox, substance abuse, mental health, or dual-diagnosis services?
- Is the patient 18 years or older?
Step 2: Determine Financial Eligibility
- Does the patient have Medicare bed days available, private insurance, or the ability to self-pay?
Step 3: Submit Patient Information for Review
If you answered “Yes” to all of the above questions, fax the following patient information to 937.256.7811 for immediate review:
- Demographic information
- Insurance information
- Patient’s photo ID
- Guardian or healthcare power of attorney contact information (if applicable)
- An assessment that includes presenting problems and behaviors/symptoms describing how the individual meets criteria for acute inpatient care
- Diagnosis sheet for medical and psychiatric evaluation
- Complete medication list
- Last doctor's note
- Most recent lab work
- Pink slip (if applicable)
- Contact information for a nurse-to-nurse report
- Completed Voluntary Admission Form
Upon receipt, an Admissions Specialist will confirm clinical and financial eligibility and then follow-up directly with an admission decision!
If you have any questions about or during the referral process, please do not hesitate to call us at 937.256.7801