after your visit
After your child’s visit, find everything you need in one place, from billing and medical records to sharing feedback, thanking staff, or getting involved as a family partner.
what to expect after your visit
We are so glad that you chose Dayton Children’s for your child’s health care needs. We hope that every interaction you had with our staff went above and beyond your expectations. But we know that just because your visit is over, doesn’t mean your experience with us is done.
In this section we’ve provided easy access to everything you need for after your visit – from billing information and how to access medical records to how to thank a staff member or share your story with us. If there is something else you need after your visit but can’t find, please feel free to contact us.
after your visit checklist
Use this checklist to help you after your child’s appointment. From scheduling follow-up appointments to sharing your feedback, billing and more, these simple steps help you know what to expect next.
You may do this when you check out for your appointment, within MyChart, by calling 937-641-4000 or we may call you to schedule. If you were referred to another clinic and haven’t been seen in that clinic before, you can schedule for many services by visiting here.
Check MyChart for a summary of your visit and to view any test results.
Did a staff member go above and beyond during your visit? Thank them or nominate them for one of our staff awards.
When your child is in the hospital or going through a difficult health journey, it can bring comfort to hear from other families. Fill out our online form to share your story and provide encouragement to other families who may go through a similar experience.
We know paying for healthcare bills can be scary and overwhelming. We are here to help. Learn more about talking with a billing expert, applying for financial assistance, paying your bill on MyChart, and more on our website.
Please complete any surveys you receive after your visit. This helps us make the experience and care we provide even better.
Family partners share their stories, ideas and experiences to help us keep improving. From a virtual e-advisory group to our patient family advisory council (PFAC), there are many opportunities to share your voice!
accessing medical records
how to request medical records
In order to obtain a copy of medical records from Dayton Children’s complete and submit a Release of Medical Information form through one of the options below. Any forms requested for you to be completed are legally required and must have a signature from a parent, guardian or patient 18 years of age or older.
- Submit the form digitally using DocuSign here.
- Download the Release of Medical Information form here, then complete and submit the form by mail, email or fax. Form is available in English or Spanish.
- Mail to:
Health Information Management
Dayton Children’s Hospital
One Children’s Plaza
Dayton, OH 45404
- Email to: medrecrequest@childrensdayton.org
- Fax to: 937-641-5404
To minimize costs, we suggest requesting a copy of specific dates of service rather than the entire medical record. If you are requesting records from an inpatient hospitalization, an “abstract” of the record gives you all the essential elements without having all the daily assessments. See FAQs below to learn more.
Allow 7-10 business days after payment processing for copies to be prepared. No same day requests will be accepted. If you have an appointment with a specific date in which you need
medical records uses and costs
There is no charge for patients or parents to receive copies of their medical records for personal use. We suggest requesting a copy of specific dates of service rather than the entire medical record. If you are requesting records from an inpatient hospitalization, an “abstract” of the record gives you all the essential elements without having all the daily assessments.
You may request copies of medical records be sent to a physician’s office for an appointment. Sending these records directly to the physician’s office is free of charge. If you have an appointment with a specific date in which you need your copies, please mark this on your authorization form. Copies will be faxed or mailed directly to the physician office. Please provide us with the physician name, full address, phone and fax number.
A third party such as an insurance company or attorney’s office can request copies of medical records. Prepayment is required on all requests that have an amount due greater than $5.00 before records are sent. You will receive an invoice in the mail before any copies are processed. If payment is not received within 30 days, your request will be cancelled. Please allow 7-10 business days after payment processing for copies to be prepared
- Retrieval Fee: $18.93
- Pages 1-10: $1.24/page
- Pages 11-50: $0.64/page
- Pages 51 and higher: $0.26/page
- Electronic medical record on CD: $6.50/flat rate
- Itemized billing statement: $20.00/each
.
FAQs
To receive a copy of an imaging CD only, including X-ray, MRI, nuclear medicine or other films, please call 937-641-3811 to request directly from radiology.
Copies of medical records can be obtained by mail, email, fax or through MyChart. Please mark your preference on your authorization form.
Please allow 7-10 business days after payment processing for copies to be prepared. No same day requests will be accepted. If you have an appointment with a specific date in which you need your copies, please mark this on your form.
If you are requesting records from an inpatient hospitalization, an “abstract” of the record gives you all the essential elements without having all the daily assessments. If you are requesting records for a physician office, an abstract of the record will give the physician an overview and summary of the patient’s care. This will usually be sufficient for continuing care.
- Discharge summary – This summary includes information about a child’s inpatient stay including their care, treatment, services provided and progress towards goals.
- History and physical – Information about the child’s current illness and any relevant history.
- Consultation reports – A physician’s findings and recommendations after examining a patient.
- Operative report(s), if applicable – Important information from the surgeon detailing their findings, technical procedures, specimens removed and post-operative diagnosis.
- Diagnostic tests
contact us
If you have questions or would like help please contact our health information management department by calling 937-641-3395 or by emailing medrecrequest@childrensdayton.org.
related links
Find more resources and information for after your visit at Dayton Children’s.
patient forms
At Dayton Children’s we know that paying for health care bills can be scary and overwhelming. That’s why our team is here to help. From our friendly billing representatives to offering financial assistance and payment plans, we will do everything we can to make paying your bills as easy as possible.
billing statements and resources
All patients will receive their billing statements from Dayton Children’s through their MyChart account. If you don’t have a MyChart account, you will receive your billing statements by mail. You can sign up for a MyChart account today to enroll in paperless statements.
Please note, you may receive other billing statements for care provided at Dayton Children’s. We are proud to partner with many other health care organizations that provide care to our patients. Below is a full list of affiliates that bill independently of Dayton Children’s that you may receive additional bills from for your child’s care. Please follow their payment instructions and contact information on those bills to pay your bill or ask any questions.
- Children’s Home Care of Dayton
- Team Health (Emergency department, prior to 11/1/2020)
- Pediatrix Medical Group of Ohio (NICU)
- Dayton Pediatric Imaging
- Hensley Pediatric Dentistry
- Orthopaedic Center for Spinal and Pediatric Care
- Children’s Care Group
- Or Pro
- Wright State Physicians
Dayton Children’s provides a price list containing our charges for room and board, emergency department, operating room, medical imaging, physical therapy and other procedures. The hospital’s charges are the same for all patients, but a patient’s responsibility may vary, depending on payment plans negotiated with individual health insurers. Uninsured or underinsured patients should consult with our admitting and billing staff to determine whether they qualify for discounts.
Have questions about your bill from Dayton Children’s? Our billing experts are available during weekdays from 8:00 am-4:30 pm to answer all your billing questions. Give us a call at 937-641-3555 or toll-free at 1-800-228-4594 (Ohio only).
payments and financial resources
You may pay your bill in full with a check or credit card through our online MyChart portal or by phone or mail.
Pay online
- View and pay your bill online today in your MyChart account here. It’s fast, easy and secure.
- Not registered for a MyChart account? Use our guest payment portal here.
Pay by phone or mail
Pay your bill over the phone Monday through Friday 8:00 am – 4:30 pm by calling 937-641-3555. Or send your payment in the mail with the form you received to:
Dayton Children’s Hospital
PO Box 933410
Cleveland, Ohio 44193-0039
Please note, Our online bill pay service is for Dayton Children’s bills only and cannot be used to pay any of our affiliates who also provide services at our locations. The following affiliates bill independently from Dayton Children’s and payment should be made directly to their offices.
Dayton Children’s is proud to partner with many other health care organizations that provide care to our patients. Below is a full list of affiliates that bill independently of Dayton Children’s that you may receive additional bills from for your child’s care. Please follow their payment instructions and contact information on those bills to pay your bill or ask any questions.
- Children’s Home Care of Dayton
- Team Health (Emergency department, prior to 11/1/2020)
- Pediatrix Medical Group of Ohio (NICU)
- Dayton Pediatric Imaging
- Hensley Pediatric Dentistry
- Orthopaedic Center for Spinal and Pediatric Care
- Children’s Care Group
- Or Pro
- Wright State Physicians
If you are unable to pay your bill in full or you would like to add an open account to a current payment plan, or if you have additional insurance coverage, please call patient accounts at 513-872-7025 or 877-238-8039.
AblePay is a free program that allows you to make payments towards your out-of-pocket medical bills (co-pays, deductibles and coinsurance). This program could save you up to 13% on your medical bills. AblePay works with any primary health insurance, including Medicare. Enroll today or find more information by visiting: www.ablepayhealth.com/daytonch/
Dayton Children’s is a not-for-profit hospital, which cares for all children regardless of financial circumstances. We are committed to working with families to help you pay your medical bills. You can apply for financial assistance before, during or after your child receives care at Dayton Children’s. Learn more who is eligible and what Dayton Children’s offers for qualifying families.
Dayton Children’s will attempt reasonable efforts to contact a family regarding their medical expenses before referring their account to a collection agency. These efforts include contact via both phone and mail. Following these collection efforts, if a family has not contacted Dayton Children’s regarding any outstanding balances; the account may be referred to an outside collection agency.
FAQs
When trying to plan for your health care costs or pay your bill you might hear these words and wonder what they mean. We’ve made it easy for you and provided some of the common definitions for you in one easy spot!
- Co-pay: the part or percentage of the bill you are responsible for
- Deductible: the amount you must pay before your insurance company will pay for services
- Precertification: you may have to let your insurance company know in advance about any medical tests or treatments the doctor has ordered. If you do not precertify before receiving treatment, the procedure may not be covered.
- Network provider: any doctor, hospital, or other provider of medical services who has agreed to participate in your insurance company’s network and to offer their services at negotiated rates. Also called a participating provider.
- Pre-existing condition: an injury or illness that existed prior to the effective date of your current insurance policy
Yes, you can opt out of paperless statements. Just log into your MyKidsChart account and complete the following steps:
- Navigate to the billing summary
- For each guarantor account listed, select “view account details”
- Select paperless billing on the right hand side, and then update
- Select the option to receive paper statements
How can I view my bill if I don’t have a MyChart account?
If you don’t have a MyChart account, you will receive paper statements. If you’d like to receive paperless statements, sign up for a MyChart account today.
Two statements will be sent digitally to your MyChart account and if no payment has been received and the guarantor has not registered for a MyChart account, the statement will be sent by mail to the guarantor address on file.
It may be because you don’t have your notifications turned on. Check your notification settings by logging into MyChart and navigating to your communication preferences or you can contact the MyChart support line at 1-877-355-3155.
Yes! Dayton Children’s is a not-for-profit hospital, which cares for all children regardless of financial circumstances. We are committed to working with families to help you pay your medical bills. We are able to provide financial assistance to individuals and families with income at or below a certain percent of federal poverty guidelines.
related links
Find more resources and information for after your visit at Dayton Children’s.
financial assistance
Dayton Children’s is a not-for-profit hospital, which cares for all children regardless of financial circumstances. We are committed to working with families to help you pay your medical bills. You can apply for financial assistance before, during or after your child receives care at Dayton Children’s. After you receive a bill, you can apply for financial assistance in MyChart.
For families that qualify, Dayton Children’s offers:
- Financial aid for Dayton Children’s health care bills.
- Assistance by trained financial counselors, including help filing for Medicaid, HCAP and State Child Health Insurance Plans.
- 100 percent financial aid, also known as charity care
Dayton Children’s will not discriminate against any person receiving health services because of his/her inability to pay for services, or because payment for the health services will be made under a financial assistance program. If the family or patient is not eligible for financial assistance programs they may still qualify for a discount on self-pay charges, or they may be able to work with patient accounts to pay any outstanding balances through such activities as setting up a payment plan, etc.
For additional information please read our financial assistance policy. You can also view the policy in Arabic, Kinyarwanda, Spanish, Swahili or Russian. View a listing of physicians covered by our policy. For a complete listing of Dayton Children’s Hospital charges please see our cost and price transparency webpage. Please note that in almost all cases the amount paid by you or your insurance will be less than these listed charges.
Please note that the following are not eligible for financial assistance:
- Children’s Home Care of Dayton
- Services rendered directly by Shriners Children’s
- On-site dental clinic services provided by Cleveland Dental
- Dayton Pediatric Imaging professional services
- certain elective procedures, such as cosmetic surgery
The first step to see what assistance you may qualify for is to either fill out a Dayton Children’s financial assistance application or contact Dayton Children’s business office at 937-641-5727 or toll-free for Ohio residents only at 1-800-228-4594. Once you have a bill, you can apply through MyChart too. The financial assistance application is also available in Arabic, Kinyarwanda, Spanish, Swahili and Russian. After the financial assistance application is completed, that data will be used to determine what programs the patient might be eligible for.
Things to know:
- Dayton Children’s provides financial assistance to individuals and families with income at or below 400 percent of the federal poverty guidelines.
- The financial assistance application can be completed before, during or after your child receives care at Dayton Children’s.
- Completed applications can be returned the following ways:
Mail to:
Dayton Children’s Hospital
Patient Family Financial Advocate
Department 1A
One Children’s Plaza
Dayton, Ohio 45404-1815
Fax to: 937-641-6101, Attn: Financial Advocate
The financial assistance application uses federal poverty levels compared with family size and income to determine the level of eligibility for financial assistance. Dayton Children’s may also use the federal poverty guideline rates as a basis for calculating discounts or Dayton Children’s may use an average percentage of negotiated rates for families that qualify for financial assistance to help determine the amount owed. There are also other ways to become eligible for financial assistance other than just using family size and income, such as a child’s medical diagnosis.
2025 federal poverty levels (FPL)
Children’s Buy-in Health Care Program
For families with income over 300 percent of the Federal Poverty Level. Families need to meet certain criteria and there are monthly insurance premiums for each child enrolled.
Montgomery County Human Services Levy
This is available to Montgomery County residents only. It provides assistance for residents with overwhelming medical bills.
Ohio Medicaid and Healthy Start
These programs provide assistance with medical bills for families whose income falls at or below the 200 percent of the federal poverty level (currently $50,200 for a family of four)
Ohio BCMH (Bureau for Children with Medical Handicaps)
This State program provides coverage for children with specific illnesses, such as cancer.
Ohio Care Assurance Program
This program provides free care for any Ohio resident whose income falls below 100 percent of the federal poverty level.
Dayton Children’s financial assistance
For qualified low-income families with large hospital bills, Dayton Children’s can provide financial assistance.
Consistent with its mission to provide comprehensive and compassionate care that improves the health of the people we serve, Dayton Children’s Hospital is committed to providing Financial Assistance to every person in need of emergency or other medically necessary treatment if that person is uninsured, underinsured, ineligible for other government programs, or unable to pay based on their individual financial situation.
Eligible Care
Financial assistance is available under our Financial Assistance Policy (FAP) for emergency care or other medically necessary care provided by Dayton Children’s Hospital for Eligible Patients.
Patient Eligibility Requirements
The Dayton Children’s Hospital Financial Assistance Program is available to uninsured patients and patients with self-pay balances after insurance that have met all financial criteria based on the disclosure of, and assessment of, proper information and documentation (Eligible Patients). FAP is a charity program based on the patient’s family income. Patients with family incomes at or below 400% of the Federal Poverty Guidelines (FPG) are eligible for financial assistance along the following sliding scale.
COVID -19 Relief
Notwithstanding the above information, for clinical services rendered the period beginning April 2020 through June 2021, Dayton Children’s may qualify patients for additional COVID-19 financial relief discount on outstanding patient balances. To be eligible for this discount the patient/family must apply for financial assistance through the normal process as outlined in this policy. Completion of this application process will qualify the patient/family, at that point, for a discount on outstanding balances. This discount will be in effect at the discretion of Dayton Children’s Hospital for a time period related to the COVID-19 impact on the Dayton area community.
Patients with family income exceeding 400% of the Federal Poverty Guidelines may still be eligible for hardship financial assistance on an individual basis. The Patients’ expenses and liabilities are considered in the evaluation of their eligibility for approval. Patients are expected to contribute payment for care based on their individual financial situations; therefore, each case will be reviewed separately. Financial Assistance is not considered an alternative option to payment, and patients may be assisted in finding other means of payment or financial assistance before approval for the Dayton Children’s Hospital Financial Assistance Program.
No Eligible Patient will be charged more for emergency or other medically necessary care than Amounts Generally Billed (AGB) for those patients who have insurance covering such care.
About the Application Process
The process for applying for financial assistance under our FAP includes these steps:
- Fill out our FAP Application Form (also referred to as the FAA) and include the required supporting documents
- Completed applications can be returned the following ways: Mail to: Dayton Children’s Hospital, Patient Family Financial Advocate, Department 1A, One Children’s Plaza, Dayton, Ohio 45404-1815, fax to: 937-641-6101 Attn: Financial Advocate, email to: FinancialAdvocates@childrensdayton.org
- The Financial Assistance Department will review your completed application along with the documentation you provided to determine your eligibility.
- We will contact you if additional information is required to complete your application process and/or when a decision has been made. Please allow 30 days for us to complete the evaluation process.
Where to Obtain Information
You may obtain a free copy of our FAP and FAP Application Form by visiting the links above or by contacting our Financial Assistance Department at 937-641-5727. Upon your request, our Financial Assistance Department will mail you a free copy of our FAP, FAP Application Form, and Plain Language Summary to the address you provide. Free Copies of the FAP, FAP Application Form, and this Plain Language Summary are available in hard copy at Dayton Children’s Hospital, Patient Account Department, One Children’s Plaza, and Dayton, Ohio 45404.
Other services which are separately billed by other providers who are not employees of Dayton Children’s Hospital, such as independent physicians, are not eligible under our FAP.
Our FAP, FAP Application Form, and Plain Language Summary are available in English, Spanish, and Russian. You can also read this policy in Arabic, Kinyarwanda, Spanish, Swahili and Russian.
ways to give feedback
At Dayton Children’s, every patient and family voice matters. Your feedback helps us celebrate what we’re doing well and find new ways to improve care for every child who walks through our doors. Whether you’d like to share your experience, thank a staff member, or get involved as a family partner, there are many ways to tell us about your experience below.
submit your patient surveys
We strive to make every experience at Dayton Children’s the best it can be for our patients and families. If you receive a patient experience survey by mail, email, or phone, please take a few minutes to tell us how we did. Your feedback helps us see care through your eyes and make meaningful improvements. If you don’t receive a survey, you can still share your thoughts by contacting patient relations at patientrelations@childrensdayton.org or 937-641-3306.
contact patient relations
Dedicated to patient and family advocacy, our patient relations team works alongside families to ensure every voice is heard and every concern is addressed with care and respect. We value your feedback—it helps us identify opportunities to improve and ensure every family receives the best possible care and experience. Contact us Monday through Friday from 8:00 am to 4:30 pm by calling 937-641-3306 or by emailing patientrelations@childrensdayton.org.
share your story
Every patient journey at Dayton Children’s is powerful — from NICU miracles to courageous cancer survivors and beyond. These patient stories not only celebrate our families but also offer hope and encouragement to others facing similar challenges. Your story could be used in a variety of ways, shared with staff involved to thank them for the care they gave, social media posts, on our website, at fundraising events, and more. Share your experience today and help inspire, support, and celebrate the strength of our patients and families.
become a family partner
Children and their families are at the heart of everything we do at Dayton Children’s. We recognize that families are experts in the care and understanding of their children, and that the voice of every family is important. When a family shares about their experiences in health care, we learn new ways to serve our families better.
Our family partner programs provide opportunities for families to join with us to promote family-centered care and improve safety, processes, and the patient and family experience.
thank a staff member
We know that everyday our staff goes above and beyond for patients. But we still love hearing about it, and so do they! Show your appreciation for the staff at Dayton Children’s. Provide as much information as you can in the form below and we will do our best to make sure it reaches our staff. For your privacy, please do not include personal information about your child.
nominate a staff member for an award
Did you experience an exceptional staff member during your visit or stay at Dayton Children’s? We offer multiple awards throughout the year to recognize staff members that go above and beyond. Explore our awards below and nominate someone today.
the DAISY Award for nurses
The DAISY Award recognizes nurses for their extraordinary acts of compassion and excellence in their works with patients, families, the community and their co-workers. All nurses, in any role, may be nominated and considered for a DAISY Award. DAISY Awards are presented quarterly and nominations are accepted at any time.
The DAISY foundation was created by Bonnie and J. Mark Barnes to honor nurses for the extraordinary work they do for patients and families everyday. Their son, J. Patrick Barnes, lost his battle to a disease attacking his immune system at the age of 33. The Barnes family was in such awe of the skillful and compassionate care that Patrick received, they created the DAISY award to honor those nurses and nurses across the world.
The award may be given to any Dayton Children’s nurse, in good standing, who exemplifies the following:
- Works collaboratively with others
- Serves as a role model for the nursing profession
- Communicates clearly and effectively with all coworkers and patients/families
- Functions as an integral member of a team
- Creates an encouraging environment for others to learn
- Generates enthusiasm and energy towards meeting the challenges of nursing
- Works with others to achieve common goals and effect positive change
- Develops key relationships with others—including patients and families
- Demonstrates excellent interpersonal skills with peers and co-workers
- Models empathy and demonstrates a caring attitude in all situations
- Demonstrates a commitment to the goals and mission of Dayton Children’s
- Strives to go above expectations in their role within Dayton Children’s
- Commitment to the highest standards of nursing
It’s easy! Submit a nomination for the DAISY Award using our online form. Please take time to write a thoughtful nomination as this will be used to select the winner and will appear with the winner’s name on national websites. Each person receiving a nomination will receive a DAISY pin.
The winning nurse is recognized in a number of ways, but his or her department or work unit is also recognized. We know that a great team contributes to an individual’s success. A member of the Clinical Operations Council will present the winning nurse his or her award the same day the winner and his or her coworkers enjoy a Cinnabon celebration.
Your online nomination is collected in nursing administration and is forwarded to the Clinical Operations Council. The council members do not see the nominee’s name. One winner per quarter is selected based on the merits of the application.
the POPPIES Award for clinical staff
The POPPIES award stands for “Power of Positive People in Excellent Service.”
The POPPIES award is given by nursing to clinical support staff, respiratory therapists, employees in rehab, environmental services, facilities, dietary, child life, etc. The award is to honor someone who has provided excellent service and partnership to nursing.
It’s easy! Submit a nomination for the POPPIES Award using our online form. Please take time to write a thoughtful nomination as this will be used to select the winner.
the PHIL Award for respiratory therapists
The PHIL (Pulmonary Health and Illnesses of The Lungs) award was created in 2006 in honor of Philip C. Lamka, who passed away from Interstitial Lung Disease (ILD). The award honors and recognizes the unsung heroes in the respiratory profession who understand that each breath matters. Patients, family members and other caregivers have the opportunity to nominate a respiratory therapist for this award anytime throughout the year.
During respiratory care week each October, the PHIL Award is presented to an outstanding respiratory therapist based on nominations received. In addition to being known as ‘the best of the best’ in respiratory care and having bragging rights, the PHIL Award winner will receive a sculpture and paid tuition to their state’s annual professional conference.
It’s easy! Submit a nomination for the PHIL Award using our online form. Please take time to write a thoughtful nomination as this will be used to select the winner.
know what to expect
Whether you’re preparing for your child’s first appointment, visiting the hospital or need to access medical records afterwards, we have all the resources you may need.
