Clinical partners and Gateway have separate roles
To understand how Gateway works with clinical partners, start with one distinction. Treating practices provide the clinical care. Gateway arranges and coordinates what surrounds it. The two roles depend on each other, but they do not overlap.
Questions about the wound, the diagnosis or the treatment go to the treating clinician. Questions about scheduling, records, supplies or next steps can come to Gateway.
What the treating practice is responsible for
Partner clinicians work within their own practices and scope. The treating clinician:
- Assesses the patient and the wound
- Makes the diagnosis
- Decides on the plan of care
- Writes clinical orders, including orders for supplies, equipment, imaging and labs
- Performs or directs treatment
- Documents the visit in the practice’s medical record
Gateway does not make or direct these decisions.
What Gateway is responsible for
Gateway handles the work that makes a visit possible and keeps the plan moving afterward:
- The request. We take the first call from a patient, family member, facility or practice and learn what is needed.
- The connection. We link the request with a treating practice that serves the patient’s location and care setting.
- The schedule. We coordinate visit arrangements with the patient, family or facility staff.
- The records. We help gather background information so the clinician has it before the visit.
- The follow-through. We follow up on orders, supplies, transportation arrangements and the next appointment.
- The communication. We keep the patient, family, facility and other clinicians informed about logistics.
Care in the setting that fits
Partner clinicians see patients where care makes sense for them. That includes mobile wound care in private homes, scheduled wound rounds in skilled nursing and other facilities, and outpatient or office visits with clinical partners.
The setting can change. When a patient goes from a rehabilitation center to home, scheduling, records and follow-up have to move too. Our page on continuity of care explains how we handle those moves across Greater St. Louis and the Metro East.
Orders, supplies, imaging and transportation
A clinician’s order often sets off work in several other offices. When a clinician orders imaging or lab work, we help connect the order with scheduling and with the return of the report to the treating team. When a clinician orders dressings or equipment, we coordinate the supply request with the responsible practice and supplier, including any facility requirements. When a patient has to travel, we help arrange transportation with the family, the facility, the health plan or a transportation provider.
Choosing products, reading results and deciding what they mean remain with the treating professionals.
Primary care in the same model
The same division of roles applies to primary care. Partner practices provide visits and, where they offer them, programs such as chronic care management, remote monitoring and transitional care after a hospital stay. Each program has its own clinical and insurance requirements, and the practice determines whether a patient qualifies.
When a patient receives both wound care and primary care, coordination helps the two clinicians work from shared information about medications, blood sugar, circulation and other factors that affect healing.
How Gateway supports the practices themselves
The model has a second side that patients rarely see. Independent practices need supplies, working administrative systems and steady referral relationships to keep seeing patients. Gateway offers practice support in those areas: clinical supplies and wound care products, billing and claims follow-up, prior-authorization tracking, credentialing, scheduling and records, and administration of care programs.
Clinical decisions, medical necessity, final coding decisions and responsibility for claims stay with the practice. Administrative help does not guarantee payment by any plan.
What the model means for referring teams
When you refer a patient, Gateway connects them with a treating practice. You can ask which practice is involved, how to reach it and how visit information will come back to you.
Physicians and practice managers can find specifics on the page for physicians. Any professional can start with the referral form, and patients and families with the request care form. Either group can call 314-325-0126.
Common questions
Who does the visiting clinician work for?
Care is provided by partner clinicians from treating practices. They work under their own practice, keep that practice’s medical records and make their own clinical decisions. If you want to know which practice is treating you, ask us or ask the clinician at the visit.
Who do I call if my wound looks worse?
Contact the treating clinician’s practice, since changes in a wound are clinical questions. Report things like spreading redness, new swelling, more drainage, a new odor, fever or increasing pain. If you are not sure how to reach the practice, call Gateway at 314-325-0126 and we will help you get to the right office. For an emergency, call 911.
Does Gateway decide which supplies or treatments I receive?
No. The treating clinician chooses the treatment and writes the orders for dressings, equipment and tests. Gateway follows up on those orders with the practice and the supplier so that what arrives matches what was ordered. If something seems wrong with a delivery, tell us or the practice and we will help sort it out.
Who bills my insurance for a visit?
The treating practice is responsible for billing and claims for the care it provides. Suppliers and transportation companies may bill separately for what they provide. Participation and benefits depend on the treating provider, your plan and the care needed, so ask the practice and your plan about costs before care begins.
Can a practice use Gateway’s support without referring patients?
Yes. An independent practice can ask about practice support by itself, whether the interest is supplies, administrative help, care-program administration or referral relationships. The practice keeps control of clinical decisions and responsibility for its claims. The practice support section is the place to start.