A service line you actually own.
The platforms will have a new therapy line running in your practice inside a week, on their entity, their pharmacy, their provider network, and often their merchant account. Kynzen builds the same line inside the practice you already run, with your certification and your banking, and hands over every credential at the end. Slower to launch. Yours to keep.
- Staffing
- No clinician on payroll
- Typical build
- 4 to 12 weeks
- Fee
- Fixed, not hourly
- Ownership
- Every credential yours
Experience
Where this comes from.
We have built this stack and taken it through LegitScript certification, connected e-prescribing, and a compounding pharmacy filling real orders. We have run controlled substance lines on synchronous video, with prescription monitoring checks and credentialed providers rather than a questionnaire. That is why the failure points are known before your build starts: which certification answers stall a file, which EMR and pharmacy combinations will not connect, and which ownership structures have to be unwound once revenue is already coming in. You get the finished path instead of the search for it.
- 8 weeks
- Realistic median from signature to live. Certification review is the variable, and expedited review is available at additional cost.
- 50 states
- National provider network coverage. What can be prescribed still varies by state and by therapy category.
The tradeoff
What renting the line costs a practice that already has patients.
You have almost certainly been pitched on this already. A platform will have a new therapy line running in your practice inside a week, on their infrastructure, for a share of the revenue. That offer is real and it works. What follows is what it costs a practice that already has patients, which is a different bill from the one a startup pays.
The share comes out of demand you already built
A revenue share is priced as though the infrastructure brought you the patients. It did not. You spent years and real money building the list the new line sells into, and then pay a percentage of that line for as long as it runs, for something that could have been bought once.
The chart splits in two
A rented line runs in their system, so your record of a patient is only part of the picture. Your clinicians read the history in two places, and month end reporting has to be assembled from two systems that were never meant to agree with each other.
It does not convey when you sell
The certification, the pharmacy relationship, and the provider agreements sit with the platform. A buyer looking closely at the practice finds that its fastest growing line is a contract that can terminate rather than an asset that transfers with the sale.
What gets built
Ten workstreams, scoped against what you already run.
You will already have some of this, and scope is set against what you actually run rather than against the full list. An existing entity usually makes the structure work lighter, though it rarely removes it, since the entity that holds a prescribing line has to carry the right licensure behind it and that is often not the one you already trade through. Payments and intake are frequently part way there. What almost never exists yet is certification, e-prescribing enrollment, and the pharmacy relationship, and those three are what set the launch date.
Corporate structure
Management company and professional entity, the services agreement between them, ownership and control mapping, and the operating documents your attorney reviews and signs off on.
Compliance blueprint
Written requirements across telehealth practice standards, prescribing rules including controlled substances, patient privacy and vendor agreements, informed consent, and record retention. Includes mapping which states permit what you intend to offer by telehealth, category by category, because that sets your addressable market and occasionally your model. Where a federal rule is actively changing, you are told which way it is moving and what that means for yours.
LegitScript certification
Readiness audit against the published criteria, remediation of what will fail, application assembly, and management of the review cycle through to a decision. Review time is the item that usually sets your launch date, so we tell you early whether expedited review is worth paying for in your case.
EMR and e-prescribing
Electronic medical record configured for your intake, charting templates, and e-prescribing connected and enrolled so your providers can actually transmit.
Pharmacy relationship
Introduction to a compounding pharmacy partner, routing set up on the prescribing side, and the fulfillment and shipping flow confirmed end to end.
Payments and billing
Payment processing configured for a healthcare merchant, one-time and recurring billing, refund and chargeback handling, and the reporting you need at month end.
Site and intake funnel
Patient-facing site, screening intake, checkout, and the handoff into your EMR so a new patient lands in the chart without anyone retyping anything.
Provider network introductions
Our list of third parties we have actually used, including national provider networks, plus the introduction and the contracting structure between them and the practice. These are recommendations, not guarantees, and you are free to bring your own as long as they are certified.
Operating procedures
Written protocols for intake review, refills, adverse events, escalation, and records requests, so the practice runs the same way on your worst week as your best.
Launch support
Ad accounts through platform review, first campaign structure, and working sessions across the first 90 days while real patients hit the system.
Process
Five steps, and you can leave after the second one with something useful.
- 01
Application
A short written intake so the first call is not spent on basics. If it is not a fit, you get told on the form, not after a sales call.
- 02
Structure call
30 minutes on your model, your states, and what you are actually prescribing. You leave with the structure you need whether or not you hire anyone.
- 03
Scope and agreement
A fixed-fee scope with named deliverables and dates. No hourly billing and no scope that expands after signature.
- 04
Build
Weekly checkpoints against a written plan. You see the stack come together rather than waiting for a reveal at the end.
- 05
Handover
Every credential, every account, every document, in your name. There is no dependency on us after the engagement closes.
The stack
Any one of these can be bought in an afternoon. The work is the seams between them.
Five systems have to agree with each other before a patient can be seen and a prescription can be filled. This is where builds stall, and every one of these is a failure we have watched happen.
Intake and checkout
Patient-facing site into the medical record
Where it breaksThe screening questionnaire is treated as a marketing form, so the answers land in an inbox instead of the chart and someone retypes them. Every retyped intake is a transcription error waiting to become a clinical one, and it does not survive volume.
Medical record
Charting, and the enrollment that lets a provider transmit
Where it breaksE-prescribing is treated as a feature you switch on. It is an enrollment, per provider, with identity proofing behind it, and controlled substances add a further credential on top. Nobody discovers this until the week they wanted to go live.
Pharmacy routing
Prescriptions out, fulfillment and shipping back
Where it breaksThe record system and the pharmacy both claim to support the same directory and still will not route to each other, or they will and nothing reports back, so nobody can answer where an order is. This pairing has to be checked before either is chosen, not after.
Certification
Everything above, plus the ability to advertise at all
Where it breaksBuilt last, when it should be started first. It gates the ad accounts and the merchant account, and the review clock runs on someone else's schedule, so a stack that is otherwise finished sits idle waiting on it.
Payments
Checkout, recurring billing, refunds, and the month-end numbers
Where it breaksA general processor is used, the account is reviewed, and it is frozen mid-launch because of what is being sold. Underwriting for this category is its own piece of work and it belongs at the start.
FAQ
What practice owners ask on the first call.
Why not just use a white-label telehealth platform?
Sometimes you should. If you want to test a market this quarter with minimal capital, a platform will have you live in a week and that is genuinely hard to beat. The trade is that you are operating on their entity, their pharmacy, their provider network, and often their merchant account, under a revenue share you do not control. That is a channel, not an asset. This is for the case where you intend to own the practice, keep the margin, and be able to sell it.
We already have an entity. Does that cut the scope?
Usually it makes the structure work lighter, and it rarely removes it. The entity you trade through today was formed for what you already do, and a prescribing line generally has to sit with an entity carrying the right licensure behind it. Sometimes that means a new professional entity alongside what exists, with a services agreement between them. You will hear which case you are in on the structure call, before anything is scoped or priced.
Will this disrupt what we already run?
It should not, and that is a design constraint rather than a hope. The new line is built alongside what exists and switched on when it is ready, so nothing about your current scheduling, billing, or patient flow changes while it is being built. The one place the two meet is the chart, and where your current system can hold the new records we configure it that way rather than standing up a second one.
Do we have to change our EMR?
Not necessarily. The requirement is not a particular product, it is that the record system can support the intake, charting, and e-prescribing the new line needs, and that it will actually connect to the pharmacy side. Some systems will, some will not, and a few will technically connect but make the daily work miserable. We check yours against what the line requires before recommending anything, and if it works you keep it.
Do I need to hire a clinician?
No, and neither option puts one on your payroll. Prescribing has to be done by an appropriately licensed provider, and that relationship is structured as an agreement with the professional entity rather than as employment by you. Under this build those agreements belong to the practice, so they survive a change of vendor. Whether we make the introduction or you bring your own is a scope question settled on the call.
What does this cost?
There is no price list, because the range is genuinely wide and a number on a page would be wrong in both directions. What moves it: how many states and therapy categories you intend to operate in, whether a usable entity already exists, whether you need the pharmacy relationship and provider introductions or are bringing your own, and how much of the execution you want to keep in house. Engagements are a fixed fee agreed in writing before anything starts, never hourly, and the scope does not move after signature. The application asks your budget range so nobody spends a call finding out the two of you were never in the same conversation.
Can you guarantee LegitScript certification?
No, and be skeptical of anyone who does. LegitScript is an independent certifying body and the decision is theirs. What we do is audit against the published criteria, fix what would fail, assemble the application, and manage the review. We tell you before you pay if we think you will not clear it.
Which states can I operate in?
Provider coverage is generally not the constraint. The networks we work with are licensed nationwide, so the practical limit is not where you can find a clinician. It is what each state allows to be prescribed by telehealth, which varies by state and by therapy category, and can differ for the same patient depending on which category they are being treated under. That mapping is part of the compliance blueprint, so it is included on every tier. You cannot sensibly build without it, since it sets your addressable market before you spend anything on getting patients.
Is this legal advice?
No. We are not a law firm and we do not practice law. We build the operational and technical structure and prepare documents for review. Your attorney reviews and signs off, and we work alongside them. If you do not have healthcare counsel, we will introduce you to some.
What is not included?
State filing fees, registered agent costs, certification fees including expedited review if you choose it, malpractice and business insurance premiums, provider compensation, software subscriptions, and ad spend. Those are paid directly by you to the vendor so there is no markup sitting in the middle.
Tell us what the practice already runs and we will tell you what the line actually takes.
The application takes about five minutes and asks what you have in place today. If it is not a fit you will know before anyone books a call, and the structure call is worth having either way.
Kynzen provides business and operational consulting. Not legal, medical, or tax advice.