Questions to ask when evaluating a telehealth platform

Every telehealth infrastructure vendor answers the same first question the same way. Yes, the brand can launch a clinic without a medical licence. Yes, there are providers. Yes, there is a pharmacy. The sales call moves on to the demo, and the demo is where most evaluations end, because the storefront looks fine and the portal looks fine and nobody has yet asked who owns the patients. The questions that decide whether a brand ends up owning a clinic or renting one are not about the software. They are about ownership, money, coverage, pharmacy, legal structure and what happens on the way out. What follows is the list, grouped by the answer each group protects, with the wording that gets a straight reply.

The list is long on purpose. A vendor with clean answers gets through it in an hour and is glad to be asked. A vendor that wants to skip sections is telling the buyer where to look.

Who owns what

Start with ownership because every later answer is priced against it. A telehealth clinic is three things the brand can own: the brand itself, a patient base with its records, and the data that describes both. Ask, one at a time, who owns each on the first day and who owns each on the last.

• On the day the agreement ends, do the patients, their records and their consent history leave with the brand, in a format another clinic can import, and how many days does the export take?
• Does the vendor's pharmacy partner or provider network have any contractual claim on the patients if the brand moves?
• Who owns the domain, the storefront code, the intake content and the marketing assets built during onboarding?

The tell is the export question. A vendor that owns the patients will describe a transition process with conditions. A vendor that does not will describe a file. The guide on who owns the patients walks through what the file has to contain for the answer to be real.

How the money works

Telehealth economics live in three lines: the platform fee, the consult fee and the medication line. Most vendors publish one of the three and negotiate the rest, and the negotiated lines are where a revenue share or a medication markup sits. Ask for every number in writing and ask which ones move with volume.

• Is the pricing published, and if not, why not?
• What is the fee per completed consult, and does it change by visit type, by state or by provider type?
• What is the medication markup over the pharmacy's wholesale invoice, in percentage terms, and can the brand see the invoice?
• Is there a revenue share on any plan, on any product line, or on any patient cohort such as maintenance patients?
• Whose merchant account collects the patient's payment, and if it is the vendor's, when and how is the brand paid?
• What are the setup fee, the monthly minimum and the contract term, and what happens to the fees when patient count doubles?

Run the answers through a spreadsheet at a thousand patients before signing. A percentage that feels small at fifty patients is the vendor's largest revenue line at a thousand, and it scales with the brand's success rather than the vendor's cost. The comparison of a flat fee against a revenue share shows how far apart the two models sit at scale. The merchant account question matters as much as the percentages: a brand that does not collect its own revenue does not control its own cash flow, its refund policy or its chargeback record.

Where the providers can actually see patients

Every vendor says fifty states. The claim means different things. It can mean a physician network licensed everywhere with capacity to match, or a handful of clinicians whose licences add up to fifty on a spreadsheet with one provider covering nine states on Tuesdays. Ask for the coverage the way an operator will experience it.

• How many providers hold a licence in each of the brand's five largest target states, and what is the current wait time for a first visit in each?
• Are the providers physicians, nurse practitioners or a mix, and in states that require physician collaboration for nurse practitioners, who holds the collaborative agreements?
• Which states does the network treat by questionnaire alone, which require a live video or phone visit, and which require an in-person visit first?
• Can the providers prescribe controlled substances by telehealth where state and federal law allow it, and is EPCS in place?
• Who orders labs, who pays the lab, and how do results reach the provider and the patient?
• What happens when a provider leaves: who re-credentials, and how long are that provider's patients without coverage?

The questionnaire question deserves particular care. Several large states require a live interaction for a new patient, and a vendor built around asynchronous intake may quietly exclude those states or treat them at a higher consult price. The brand should know which states it is buying before it buys the marketing.

How the medication reaches the patient

Pharmacy is the line most evaluations skip because it feels like the vendor's problem. It becomes the brand's problem the first time a shipment arrives warm or a patient in a strict state cannot be served. A pharmacy has to hold a licence in every state it ships into, a separate permit for sterile products in many of them, and a documented cold chain for anything that ships refrigerated.

• Which pharmacies fill the brand's prescriptions, and can the vendor produce each one's state-by-state licence list, including sterile permits?
• Are the products 503A patient-specific compounds, 503B outsourcing-facility products or manufacturer-branded products, and what is the plan if a compounded product loses its legal basis?
• What is the cold-chain standard, what carrier cutoffs apply, and who pays when a shipment fails: the pharmacy, the vendor or the brand?
• How long from prescription to delivery in the brand's largest states, and what does the patient see while waiting?
• If a state cannot be served by the primary pharmacy, does routing to a second pharmacy happen automatically or does the patient fall out?

A vendor that cannot produce the licence list has not looked, and a vendor that will not name its failure policy expects the brand to eat the refunds.

The questions a vendor is glad to answer describe the clinic it built. The questions it steers around describe the clinic the brand will actually run.

Is the legal structure sound

In most states a company not owned by physicians cannot practise medicine or employ physicians to do it, which is why compliant telehealth runs as two entities: a physician-owned professional corporation that does the clinical work and a management services organization, owned by the brand, that does everything else. Every vendor will say it has this structure. The questions are whether it was built by healthcare counsel and whether it holds up in the strictest states.

• Does the MSO and friendly-PC structure already exist, who drafted and reviewed it, do licensed clinicians run the practice, and is the management services agreement available for the brand's own counsel to read?
• Is the management fee a flat amount or a percentage of collections, and has healthcare counsel reviewed it against the fee-splitting rules in the brand's largest states?
• Who holds the LegitScript certification the ad platforms require for prescription-drug advertising, the brand or the vendor, and can the brand take it when it leaves?
• Who signs the business associate agreement, and which party is the covered entity for the patient records?
• Has the structure been reviewed for the corporate practice rules in California, Texas and New York specifically, since those states set the floor for a national footprint?

A structure that fails in one strict state fails for the whole footprint, because the same documents govern every patient. It is worth an hour with counsel before signing rather than a quarter with counsel after.

What launching and running actually involve

Launch timelines are quoted in days and delivered in months when the vendor's number assumes the brand has already done the parts the vendor does not do. Ask for the timeline as a list of steps with an owner beside each one.

• From signed agreement to first patient, which steps does the vendor own, which does the brand own, and which depend on a third party such as an ad platform, a bank or a state board?
• What retention tooling is included: refill reminders, failed-payment recovery, titration check-ins, dashboards by cohort?
• Who answers the patient's message at nine at night, and what is the response-time standard?
• What does the vendor's security posture look like in writing: a SOC 2 Type II report, a HIPAA risk assessment, breach notification terms?
• Which named client can the brand call, running in the same category at a similar size?

The retention question is not a feature request. In a subscription clinic most churn is drift, a failed card or a missed refill, and a platform that cannot see the prescription cannot catch the drift. A vendor that treats retention as the brand's marketing problem has priced the brand's biggest cost line at zero.

How the relationship ends

Read the termination clause before the pricing page. A month-to-month term is offered by vendors confident the clinic performs; a multi-year lock-in with a termination fee says the opposite. Then read what the vendor may do to the brand without notice.

• What is the notice period on each side, and what does the brand owe if it leaves early?
• Can the vendor suspend or terminate the account at will, and what happens to patients mid-treatment if it does?
• During transition, do prescriptions and refills continue, and for how long?
• Is there a non-solicitation clause that reaches the brand's own patients or providers?
• What does the data export contain, in what format, and is there a fee?

The exit terms are where the ownership answers from the first section get tested. A vendor that says the brand owns the patients and then prices the export or restricts the transition has answered the first question twice, differently. The guide on what happens when a brand leaves the platform sets out what a clean exit looks like in practice.

How Tessic Health answers the list

Tessic Health publishes its answers so a brand can run this list before the first call. The economics are on the pricing page: a flat monthly platform fee, $25 per completed consult, 0% medication markup on wholesale pass-through, no revenue share on any plan, and month to month after a one-time setup. Providers licensed in all 50 states are on every plan from the first day, with e-prescribing and EPCS, lab ordering, and a wholesale pharmacy network with cold-chain home delivery. The MSO and friendly-PC structure is already in place and run by licensed clinicians, and the LegitScript application is handled as part of setup. The brand, the patients, the records and the data belong to the client, who can leave at any time with all of it. The comparison pages set those terms beside every other partner a brand is likely to shortlist, using each vendor's own public materials.

Questions operators ask

Does a cheaper platform fee justify a revenue share? Rarely past a few hundred patients. A revenue share is priced against the brand's growth, so the discount on the fixed fee is repaid many times over once the clinic works. Model both at the patient count the brand expects in year two, not at launch.

Is a demo of the software worth the time? Yes, but after the list, not before. The storefront and portal are the easiest parts of the clinic to replace; the provider coverage, the pharmacy licensing and the legal structure are not. A good demo is a reason to keep talking, not a reason to sign.

Which single answer should end a conversation? A medication markup the vendor will not put in writing. It is a hidden revenue share that grows with every refill, and a vendor that hides it has usually hidden the export terms too.

Should a brand ask a vendor for its competitors' weaknesses? No. Ask each vendor the same list in the same words and compare the answers side by side. The vendor with the fewest conditions attached to ownership, money and exit is usually the one to shortlist.