The Lithos glossary
Clear definitions of the compliance, pharmacy, and clinical-operations concepts behind modern telehealth.
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503A compounding pharmacyA 503A compounding pharmacy is a state-licensed pharmacy that prepares customized medications for individual patients in response to a specific prescription, operating under Section 503A of the Federal Food, Drug, and Cosmetic Act.503B outsourcing facilityA 503B outsourcing facility is an FDA-registered manufacturer that compounds large batches of medications without patient-specific prescriptions, under full current Good Manufacturing Practice (cGMP) requirements.
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Agentic healthcareAgentic healthcare is a model of care delivery in which AI agents carry out multi-step tasks on behalf of patients and care teams — collecting intake, requesting prescriptions and refills, ordering labs, and tracking orders — while licensed clinicians make and sign every clinical decision.Agentic prescribingAgentic prescribing is a workflow in which an AI agent prepares and submits a prescription request — matching the patient, assembling the intake, selecting from an approved treatment catalog — and a licensed clinician reviews the case, decides, and signs the prescription, which is then transmitted electronically to a pharmacy.AI agent (in healthcare)An AI agent in healthcare is software that uses a language model to pursue a goal through a sequence of actions — calling APIs, reading records, asking the patient questions — rather than answering a single prompt; in clinical settings it operates inside guardrails that reserve diagnosis and prescribing for licensed clinicians.AI prescribing (AI prescriptions)AI prescribing — often searched as “AI prescriptions” or “prescribe using AI” — describes the use of artificial intelligence in the prescribing process; in the United States AI cannot legally prescribe medication, so in practice the term means AI that prepares, checks, and routes prescription requests for a licensed clinician to decide and sign.AI refills (agentic refill requests)An AI refill is a medication refill or renewal that an AI agent requests on a patient’s behalf — checking eligibility, collecting a brief follow-up, and submitting the request — with a licensed clinician authorizing the new prescription before a pharmacy fills and ships it.Anti-kickback statuteThe federal anti-kickback statute (AKS) makes it a crime to knowingly offer or receive anything of value to induce referrals of business payable by federal healthcare programs — with safe harbors protecting defined arrangements that fit them exactly.API sandboxAn API sandbox is a test environment that behaves like the production API — same endpoints, schemas, and webhooks — but touches no real patients, clinicians, or pharmacies, so a team can build and verify a telehealth integration end to end before anyone receives care.Asynchronous telehealthAsynchronous telehealth (store-and-forward) is a care model in which the patient submits health information — an intake questionnaire, photos, lab results — that a licensed clinician reviews and acts on later, without a live video or phone encounter.Audit logAn audit log is the append-only, timestamped record of every action taken on a patient’s care — who viewed a record, what a clinician decided, when a prescription was signed, which system created an order — that HIPAA requires for access to protected health information and that boards, auditors, and acquirers ask for first.
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B2B2CB2B2C (business-to-business-to-consumer) is a distribution model where a digital health company sells through organizations — employers, health plans, health systems — that offer the program to their populations.Beyond-use date (BUD)A beyond-use date is the date after which a compounded preparation should not be used, assigned by the compounding pharmacy based on USP standards and stability data — the compounded-drug equivalent of a manufacturer’s expiration date, and usually much shorter.Business Associate Agreement (BAA)A Business Associate Agreement (BAA) is the HIPAA-required contract between a covered entity (or another business associate) and a vendor that handles protected health information on its behalf, making the vendor directly liable for safeguarding that data.
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Care planA care plan is the longitudinal container for treating a condition — the protocol, encounters, prescriptions, labs, and follow-ups that belong to one ongoing course of care.Cash-pay healthcareCash-pay healthcare is care the patient pays for directly — per visit or by subscription — with no insurance claims involved; it is the dominant payment model in DTC telehealth.Certificate of analysis (CoA)A certificate of analysis is a document from a supplier or testing lab reporting the identity, purity, potency, and other test results for a specific lot of a bulk drug substance or finished preparation — the paper trail that shows a compounded medication was made from what it claims to be made from.cGMP (current Good Manufacturing Practice)cGMP is the FDA’s set of manufacturing-quality regulations for drug producers — covering facilities, equipment, personnel, process controls, testing, and records — that 503B outsourcing facilities must follow and that traditional 503A compounding pharmacies are not held to.ClearinghouseA healthcare clearinghouse is the intermediary that validates, formats, and routes electronic claims between providers and payers — the switchboard medical billing runs through.Clinical protocolA clinical protocol is the written, clinician-approved set of rules a telehealth program follows for a treatment — who is eligible, what must be screened, how the medication is started and adjusted, when follow-up happens, and what triggers escalation — so that care is consistent across every clinician and every patient.Clinician capacity planningClinician capacity planning is the process of matching licensed clinician-hours to expected telehealth encounter volume — by encounter type, by state of licensure, and by hour of coverage — so that turnaround promises hold at peak demand without paying for idle time.Cold-chain shippingCold-chain shipping is the temperature-controlled packaging and transport of medications that must stay refrigerated — such as compounded GLP-1 injectables and many peptides — from the pharmacy to the patient’s door.Collaborating physicianA collaborating physician is a licensed doctor who formally supervises or collaborates with nurse practitioners or physician assistants where state law requires it, enabling those clinicians to practice and prescribe.Collaborative practice agreementA collaborative practice agreement is the written contract, required in reduced- and restricted-practice states, that defines how a physician collaborates with or supervises a nurse practitioner or physician assistant — covering scope, prescriptive authority, chart review, availability, and the ratio of clinicians per physician.Compounded GLP-1sCompounded GLP-1s are pharmacy-prepared versions of medications like semaglutide and tirzepatide — compounded broadly during the branded drugs’ FDA shortages, and since operating through the patient-specific pathway: preparations tailored to an individual patient’s documented clinical needs.Compounded medicationsCompounded medications are drugs prepared by a pharmacy for an individual patient — combining, altering, or formulating ingredients outside FDA-approved manufacturing — under Section 503A or 503B of federal law.Corporate practice of medicine (CPOM)The corporate practice of medicine (CPOM) doctrine is a set of state laws prohibiting corporations and non-physicians from practicing medicine or employing physicians to provide care, which is why most telehealth companies operate through a separate physician-owned medical group.Cost per encounterCost per encounter is the fully loaded cost of delivering one clinical encounter in a telehealth program — clinician review, platform or infrastructure fees, pharmacy and shipping when a prescription results, payments, support, and an allocated share of fixed overhead — and it is the unit-economics denominator for programs operating at volume.CPT codesCPT (Current Procedural Terminology) codes are the five-digit codes maintained by the American Medical Association that describe medical services and procedures — the universal language of billing for what was done.
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Direct primary care (DPC)Direct primary care (DPC) is a membership model where patients pay their primary care practice a flat monthly fee for unlimited access, cutting insurance out of the primary care relationship entirely.Drug utilization review (DUR)Drug utilization review (DUR) is the structured check of a prescription against the patient’s history and clinical criteria — screening for interactions, duplications, contraindications, and misuse before and after dispensing.DTC telehealthDirect-to-consumer (DTC) telehealth is a model where a brand markets a treatment program straight to patients online, with the clinical visit, prescription, and fulfillment happening behind that brand.
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e-Prescribing (eRx)e-Prescribing (eRx) is the electronic transmission of a prescription from the prescriber’s system directly to a pharmacy, replacing paper and fax with a structured, verifiable digital order.EHR (electronic health record)An electronic health record (EHR) is the software system of record for patient care — charts, medications, orders, notes, and results — designed to be shared across clinicians and care settings.EncounterAn encounter is a single clinical interaction — a visit, async review, or follow-up — with its own documentation, clinical decision, and outcome; the atomic unit of care delivery and billing.EPCSEPCS (Electronic Prescribing for Controlled Substances) is the DEA-regulated framework that allows prescribers to send prescriptions for controlled substances electronically, requiring identity-proofed prescribers, two-factor authentication, and certified prescribing software.
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Fee splittingFee splitting is the prohibited sharing of professional fees between a licensed clinician and someone who did not provide the care — the state-law doctrine that constrains how management companies, marketers, and platforms may be paid from clinical revenue.Fee-for-serviceFee-for-service (FFS) is the payment model where providers bill for each individual service rendered — every visit, test, and procedure coded and reimbursed separately.FormularyA formulary is the list of medications a health plan covers, organized into cost tiers and managed by its PBM — the document that decides what a prescription costs an insured patient at the counter.Full practice authorityFull practice authority is a state licensure model that lets nurse practitioners evaluate, diagnose, order tests, and prescribe — including controlled substances in most such states — under the nursing board’s authority alone, without a physician collaboration or supervision agreement.
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GLP-1 (glucagon-like peptide-1 agonists)GLP-1s are a class of medications that mimic the hormone glucagon-like peptide-1 — originally developed for type 2 diabetes, now the drug class behind the modern medical weight-loss market and the largest category in DTC telehealth.GLP-1/GIP dual agonistsGLP-1/GIP dual agonists activate two incretin hormone receptors at once — the mechanism behind tirzepatide, whose weight-loss results reset expectations for the category and pulled drug development toward multi-agonism.Good faith exam (GFE)A good faith exam is the initial clinical evaluation a licensed clinician performs before a patient receives a medical treatment — the visit that establishes the patient relationship, confirms the treatment is appropriate, and authorizes it.
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Headless telehealthHeadless telehealth is an architecture in which the clinical back end — clinician network, prescribing, pharmacy, labs, compliance — is delivered as an API with no patient-facing interface of its own, so the brand builds the entire patient experience in its own product and calls the API for the medicine.HIPAAHIPAA (the Health Insurance Portability and Accountability Act of 1996) is the US federal law that sets privacy, security, and breach-notification rules for protected health information held by healthcare organizations and their vendors.Human-in-the-loopHuman-in-the-loop is a system design where automation or AI handles routing, drafting, and orchestration, while a licensed human makes the consequential decision — in healthcare, the clinician who reviews and signs.
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ICD-10 codesICD-10 codes are the standardized diagnosis codes (ICD-10-CM in the US) that describe why care happened — pairing with CPT codes, which describe what was done, to justify medical necessity.Idempotency keyAn idempotency key is a unique value a client sends with an API request so that if the same request is retried — after a timeout, a crash, or a duplicate webhook — the server performs the action once and returns the same result, which in telehealth prevents duplicate patients, duplicate encounters, and duplicate prescriptions.Identity proofingIdentity proofing is the process of verifying that a person is who they claim to be to a defined assurance level — required for prescribers under EPCS and increasingly standard for patients in telehealth programs.
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Management services organization (MSO)A management services organization (MSO) is the business entity in the “friendly PC” structure that provides non-clinical services — technology, staffing, billing, marketing — to a physician-owned medical group, allowing a company to build a healthcare business without unlawfully practicing medicine.MCP server (Model Context Protocol)An MCP server is a service that exposes tools, data, and prompts to AI assistants through the Model Context Protocol, an open standard that lets an agent discover what a system can do and call it directly — in healthcare, the way an assistant can be given the ability to register a patient, request a refill, or check an order without custom integration code for each assistant.Med spaA med spa (medical spa) is a hybrid business offering medical aesthetic and wellness services — injectables, laser treatments, IV therapy, and increasingly weight-loss and hormone programs — under required medical oversight.Medical intakeA medical intake is the structured questionnaire that collects a patient’s history, medications, allergies, and condition-specific details — the clinical substrate an asynchronous visit is built on.
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NCPDP SCRIPTNCPDP SCRIPT is the national messaging standard US e-prescribing runs on — the structured formats that carry new prescriptions, renewals, changes, and cancellations between prescriber systems and pharmacies.Non-resident pharmacy licenseA non-resident pharmacy license is the authorization a pharmacy needs from a state it ships into but is not physically located in — the licensing layer that makes national mail-order fulfillment legal.NPI (National Provider Identifier)An NPI (National Provider Identifier) is the unique 10-digit number every US healthcare provider and organization uses on claims, prescriptions, and clinical documents — issued free by CMS through the NPPES registry.
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Patient brokeringPatient brokering is paying or receiving anything of value in exchange for referring patients to a healthcare provider or facility — prohibited by state laws such as Florida’s Patient Brokering Act that, unlike the federal Anti-Kickback Statute, apply to cash-pay and privately insured patients as well as government programs.PayerA payer is the organization that pays for healthcare services — a commercial insurer, a government program like Medicare or Medicaid, or an employer funding its own health plan.PCACPCAC (the FDA’s Pharmacy Compounding Advisory Committee) is the advisory body that reviews substances nominated for the compounding bulks lists and recommends whether pharmacies should be allowed to compound with them.PDMP (Prescription Drug Monitoring Program)A prescription drug monitoring program is a state-run database that records controlled-substance prescriptions dispensed to patients in that state, which prescribers are required to check — in most states before prescribing — to identify duplicate therapy, dangerous combinations, and doctor-shopping.Peptides (therapeutic)Therapeutic peptides are short chains of amino acids used as drugs — a spectrum running from fully approved medications (GLP-1s are peptides) to investigational compounds like BPC-157 whose compounding status is actively being decided.Pharmacy benefit manager (PBM)A pharmacy benefit manager (PBM) is the intermediary that administers prescription drug benefits for payers — building formularies, negotiating manufacturer rebates, and processing claims at the pharmacy counter.PHI (protected health information)PHI (protected health information) is individually identifiable health information held or transmitted by a HIPAA-covered entity or its business associates — the data class HIPAA exists to protect.PMPM (per member per month)PMPM pricing charges a flat fee per active patient per month regardless of how many visits, orders, or messages that patient generates — a pricing model borrowed from managed care that some telehealth infrastructure vendors and clinical-service partners use instead of per-visit or platform-plus-usage pricing.Prior authorizationPrior authorization (PA) is a payer requirement that a clinician obtain approval before a specific drug, test, or procedure will be covered — a cost-control gate between the prescription and the pharmacy counter.
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Refill lapse rateRefill lapse rate is the share of active patients in a period whose medication supply ran out before their next shipment arrived — computed per patient from the last shipment date plus days’ supply against the next delivery date — and it is the leading indicator of churn in subscription telehealth.Remote patient monitoring (RPM)Remote patient monitoring (RPM) is care delivered by collecting patient health data — weight, blood pressure, glucose, wearable metrics — outside the clinic, with clinicians reviewing trends and intervening between visits.REMSA REMS (Risk Evaluation and Mitigation Strategy) is an FDA-required safety program attached to certain drugs whose risks demand more than labeling — extra requirements on prescribers, pharmacies, and sometimes patients before the drug can be dispensed.RetatrutideRetatrutide is Eli Lilly’s investigational triple agonist (GLP-1/GIP/glucagon) in late-stage trials for obesity — not FDA-approved, and therefore not something any compliant program can offer, despite heavy search demand.Revenue cycle management (RCM)Revenue cycle management (RCM) is the process healthcare organizations use to get paid for care — verifying coverage, capturing and coding charges, submitting claims, posting payments, and working denials.Ryan Haight ActThe Ryan Haight Act (2008) is the federal law requiring an in-person medical evaluation before controlled substances may be prescribed online — the statute whose telemedicine exceptions and temporary flexibilities govern what telehealth prescribing of controlled substances is allowed today.
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SemaglutideSemaglutide is Novo Nordisk’s GLP-1 receptor agonist — sold as Ozempic and Rybelsus for type 2 diabetes and Wegovy for weight management — the molecule that made GLP-1 a household term.SuperbillA superbill is an itemized receipt of care containing the diagnosis and procedure codes an insurer needs, given to the patient so they can seek reimbursement from their own plan for cash-pay or out-of-network care.SurescriptsSurescripts is the dominant e-prescribing network in the United States, connecting prescriber software to pharmacies so that electronic prescriptions, refill requests, and medication histories travel as standardized NCPDP SCRIPT messages — the rails almost every telehealth prescription rides from the clinician’s signature to the pharmacy’s queue.Synchronous telehealthSynchronous telehealth is a live, real-time encounter between a patient and a clinician — video or phone — as opposed to asynchronous care, where information is submitted and reviewed later.
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Telehealth informed consentTelehealth informed consent is the patient’s documented agreement to receive care through telehealth after being informed of how it works, its limitations, and their rights — required by law or medical-board rule in most US states before treatment begins.Telehealth modality lawsTelehealth modality laws are the state rules governing how a valid patient-clinician relationship may be established and maintained — whether by asynchronous review, audio-video, audio-only, or in-person — and which services each modality may support.TelemedicineTelemedicine is the remote delivery of clinical care — diagnosis, treatment, and prescribing — by licensed clinicians using video, phone, or asynchronous technology.TelepharmacyTelepharmacy is the remote delivery of pharmacy services — prescription verification, patient counseling, and dispensing oversight — by licensed pharmacists using technology instead of physical presence.Third-party administrator (TPA)A third-party administrator (TPA) runs the operations of a self-funded employer health plan — processing claims, managing networks, and administering benefits — while the employer bears the actual cost of care.TirzepatideTirzepatide is Eli Lilly’s dual GLP-1/GIP agonist — sold as Mounjaro for type 2 diabetes and Zepbound for weight management — the current efficacy benchmark in the weight-loss category.TitrationTitration is the clinical practice of adjusting a medication dose stepwise — starting low and increasing on a schedule — to reach effectiveness while managing side effects.Treatment catalogA treatment catalog is the approved list of medications, doses, and services a telehealth program can request for its patients — each entry tied to a clinical protocol, a category, and the pharmacies that can fill it — so that every request a product or agent makes is drawn from a defined, clinician-governed set rather than free text.Turnaround time (clinical TAT)Turnaround time in asynchronous telehealth is the elapsed time from a patient submitting intake to a licensed clinician’s decision, reported as a distribution — median and 90th percentile — by encounter type and state, because the patients who wait longest are the ones who churn.
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WebhooksWebhooks are HTTP callbacks a platform sends when something happens — in clinical infrastructure, the event stream (encounter completed, prescription signed, order shipped) that lets a product react to care in real time.White-label telehealthWhite-label telehealth is infrastructure that lets a company launch care under its own brand — clinicians, pharmacy network, and compliance run behind the scenes while the patient only ever sees the brand.