What investors ask about your clinical model, and how to answer

Answer with documents, not descriptions

Telehealth due diligence covers seven areas of your clinical model, and the questions barely change between firms. Answer each with a document and the clinical section moves quickly. Answer with descriptions and it turns into weeks of follow-ups.

Built on licensed infrastructure, five of the seven areas are answered mostly through one agreement. Compliance and unit economics stay yours to prove.

What a strong answer looks like in each area

Clinical structure. Name the structure in one sentence and point to the agreements. With your own PC/MSO, that is the management services agreement, the succession agreement and counsel’s memo; our guide to PC/MSO structures explains each. On infrastructure, diligence reads one contract.

Licensure. Show a matrix of states, allowed modalities, licensed clinicians and pharmacies that ship there. It should match where your ads run, and intake should screen out states you can’t serve. Our 50-state compliance checklist shows what belongs in it.

Prescribing oversight. Named clinical leadership approves protocols, which carry version dates. A licensed provider in the patient’s state decides every encounter. If AI is involved, it prepares the chart; a licensed provider reviews and makes the clinical decision. Controlled substances follow current DEA telemedicine rules, which are still changing.

Compliance. Investors dig into your own house here, whatever your clinical setup:

• A signed BAA from every vendor touching PHI: infrastructure, hosting, email and SMS, support, analytics.
• A documented review of tracking on intake pages. Our post on HIPAA and the marketing stack covers where this goes wrong.
• A review step for ad and creator claims, and a counsel-approved policy on referral payments.
• Your LegitScript certification status, which ad platforms commonly require.

Lithos is HIPAA compliant, signs a BAA at onboarding and has SOC 2 Type II in progress.

Medication. Name the pharmacies and show their licensure against your patient states. For compounded medications, show patient-specific prescriptions filled by licensed 503A pharmacies, cleanly documented. That is lawful practice done properly. For branded medications, show how benefits checks and prior authorization work. On Lithos, medication passes through at pharmacy cost, plus a small flat fee on mail-order orders.

Data ownership. Point to the clause: you own the patients and data, can export at any time, and have a defined transition. Portability keeps your pricing negotiable. Read this clause most carefully on any infrastructure contract.

Unit economics. Show cost per visit by type, medication as a pass-through, contribution per patient per month and CAC payback. Our telehealth startup runway model builds this month by month. Lithos is free to start, with no setup, implementation or platform fee: $45 async and $70 sync per completed visit on pay-as-you-go, falling with volume.

What goes in a telehealth data room?

Eight red flags that slow a round

1. “Nationwide” coverage with no matrix behind it.
2. Ads that promise outcomes the protocols don’t support.
3. Unreviewed tracking pixels on intake pages.
4. A vendor touching PHI without a BAA.
5. One pharmacy and no backup plan.
6. One clinician or physician owner carrying the practice, with no succession plan.
7. No export right, or an export nobody has tested.
8. Medication revenue counted as margin.

None kills a deal alone. Four or five add weeks.

Run the clinical call like a demo

Many investors hold a call just for the clinical model, often with an outside clinician listening.

1. Send a one-page memo the day before. One paragraph per area, each pointing to its data room folder.
2. Walk one patient through the flow. Intake, provider decision, prescription, pharmacy order, renewal. A sandbox shows every state change without real patient data.
3. Bring the right people. The founder who owns the clinical relationship, your clinical lead and whoever built the integration.
4. Answer follow-ups in writing within days, and file them. The same questions come back next round.

Be plain about what isn’t done. “SOC 2 Type II is in progress” is a fine answer. Overstating where you are damages trust, because investors check.

Frequently asked questions