FAQs
What are the operating hours?
Our Hyannis location operates from Monday to Friday, 8:30am – 5pm, and Saturdays from 9am – 1pm. The Falmouth location (retail only) is open Monday to Friday, 9am – 4pm. Both Hyannis and Falmouth are closed on Sundays and certain holidays, including Memorial Day, Labor Day, Christmas, New Year’s, Thanksgiving, Columbus Day, and July 4th. For more information and to reach out to us, please visit our contact page.
Do you deliver?
At West Gate, we provide efficient home delivery for eligible products covered by insurance, private purchase, and rentals. Our delivery service operates daily across Cape Cod, ensuring timely delivery and setup of equipment. Typically, regularly stocked supplies are delivered within 2-3 business days after placing the order, given that all required documents have been received. For insurance-covered orders, the setup or installation of equipment is complimentary, while a delivery fee of $25 – $50 applies to private pay equipment and supplies, depending on the area.
What is your service area?
West Gate Home Medical services Barnstable county, Cape Cod and the Islands.
What information do I need to provide?
The most common pieces of information we will need are your name, date of birth, address, phone number, and insurance information. With insurance information, we will also need your next of kin and your doctor’s name. We may also need information like your height and weight.
The specific documentation required for durable medical equipment (DME) or Supplies can vary depending on the type of equipment being requested and the policies of the insurance company or healthcare program. However, in general, the following documentation may be required:
- Prescription from a healthcare provider: A prescription or order from a licensed healthcare provider is typically required to request DME. The prescription should include the specific type of equipment or supplies being requested, the frequency of use, and the duration of treatment.
- Medical records: The insurance company or healthcare program may request medical records or other documentation to support the need for the requested equipment. This may include documentation of the patient’s medical condition, previous treatments, and other relevant information.
- Proof of medical necessity: The insurance company or healthcare program may require documentation demonstrating that the requested equipment is medically necessary and appropriate for the patient’s condition. This may include a letter of medical necessity from the healthcare provider, outlining why the equipment is needed and how it will benefit the patient.
- Cost estimates: The insurance company or healthcare program may require documentation of the cost of the requested equipment, including estimates from suppliers or other providers.
- Other documentation: Depending on the specific requirements of the insurance company or healthcare program, other documentation may be required, such as authorization forms, supplier agreements, or documentation of compliance with any relevant regulations or standards. It’s important to note that the specific requirements for documentation may vary depending on the insurance company or healthcare program, as well as the type of DME being requested.
Why am I receiving a bill for this? I was under the impression that it would be covered by my insurance.
It appears that there may be a deductible associated with your insurance plan, which means that you are responsible for paying a certain amount before your insurance coverage kicks in. Once your insurance has processed the claim, there may be additional costs such as coinsurance or remaining deductible that apply. It’s essential to review your insurance policy to understand the specifics of your coverage and any financial responsibilities you may have for this particular claim.
Why am I getting a bill for an item I received last year, every month? My insurance paid for that.
The item you received is actually part of an ongoing rental agreement. In these cases, insurance companies typically do not purchase the equipment upfront; instead, they cover the rental costs until the purchase price is met. The duration of the rental period before it converts to a purchase can vary depending on your insurance coverage. We can provide you with more specific information about the rental duration based on your insurance policy. It’s important to note that as long as you continue to medically need the item, your insurance will continue to cover the rental costs for the specified period.
I faxed this paperwork over last week, why is it not processed yet and what else do I need to do?
Please allow 2-3 business days for your order to be received and reviewed. Sometimes, there can be additional documentation or information required from the doctor’s office, which can cause a slight delay in the processing time. Rest assured, our team is working diligently to ensure that all necessary information is obtained and your order is processed as quickly as possible. If there are any additional documents or information needed, we will contact you promptly to request them. Thank you for your patience in this matter.
Why was I not informed that more information was needed?
The process of onboarding customers into our system and verifying information can take some time. Currently, our insurance verification department is handling a high volume of requests that need to be processed. Rest assured that once your information has been reviewed, our team will promptly reach out to you via phone, email, or fax to request any additional information necessary to process your order.
What is the purpose of prior authorization and why is it required?
Prior authorization is a process used by insurance companies to determine if a specific medical treatment, procedure, or medication is necessary and covered under the policy. It serves as a way to ensure appropriate and cost-effective healthcare. Prior authorization helps insurance companies review the medical necessity of certain services or medications before they are provided to ensure they meet the required criteria for coverage. By obtaining prior authorization, it helps ensure that you receive the appropriate and covered healthcare services while avoiding potential claim denials or unexpected costs.
What are the distinctions between a deductible, coinsurance, and a copay?
A deductible is the amount you are responsible for paying out of pocket before your insurance coverage kicks in. It is a fixed annual amount that you must meet before your insurance starts paying for covered services.
Coinsurance, on the other hand, is the percentage of the costs you are responsible for paying after you have met your deductible. For example, if your insurance plan has a 20% coinsurance, you would pay 20% of the allowed amount for a covered service, while the insurance company would cover the remaining 80%.
A copay, on the other hand, is a fixed amount you pay for a specific service or medication. It is typically a set fee, such as $20 for a doctor’s visit or $10 for a prescription. Copays are paid at the time of service or purchase, regardless of whether you have met your deductible.
In summary, a deductible is the amount you must pay before your insurance coverage starts, coinsurance is the percentage you pay for covered services after meeting the deductible, and a copay is a fixed amount you pay for specific services or medications.
What will be the expense for me?
The cost can vary significantly based on your insurance provider and plan. It’s best to contact your insurance company to determine the coverage details and any applicable deductible or coinsurance. It’s important to note that you may only receive an estimate once the claim is processed.
What should I do in the event of an emergency?
In the event of an emergency, it is important to refer to your Emergency Preparedness sheet, which you should have received when you started with us. This sheet will provide you with specific guidelines and instructions tailored to your situation. It is essential to keep this sheet in a safe and easily accessible place so that you can quickly refer to it when needed. If you have any questions or concerns about emergency procedures, please feel free to contact us directly for further assistance.