Four stages, in this order. The first one is free and frequently ends with us telling somebody they do not need what they came for.
1. The state and menu review
You tell us where you operate and what you want to offer. We tell you what structure that combination actually requires: whether corporate practice of medicine is restricted there, whether a facility license or registry is involved, who may perform each item on your menu, and whether your existing entity and agreement survive a look. Nothing is signed at this stage.
This is also where we tell you if the answer is “less than you think” — an Arizona NP-led clinic often does not need a medical director at all.
2. Structure and agreements
Where a professional entity is required, we form or realign it. The management agreement is written to the state rather than to a national template, with a fixed, fair-market fee agreed in advance, real physician control over clinical policy and personnel, and termination rights that work in both directions. Your counsel reviews it; we give them something concrete to review rather than a brochure.
3. Providers, protocols and platform
We name the medical director, staff licensed providers in your states, and write the protocols and delegation against your real service list. Where prescriptions or injectables are involved we stand up the good faith exam workflow on our own platform, connect pharmacy routing and, if you need it, lab draws.
4. Operate, and stay current
You go live. We keep credentialing, protocols and documentation current as the rules move — and they move constantly. In the last eighteen months alone: California’s SB 351, Texas’s vetoed injectables bill and its new IV therapy law, the end of shortage-era GLP-1 compounding, the hormone therapy label change, and a federal telemedicine deadline for controlled substances at the end of 2026. Adding a state or a service line is a change order, not a new project.
What it costs
A fixed monthly fee, quoted after stage one, scoped to the states involved, the number of locations and providers, and whether you need the platform and provider network or only medical direction. We do not quote a percentage of your revenue, because several states prohibit paying a management company a share of clinical collections and New York prohibits it outright.
Anyone quoting you a flat national price before asking which states you operate in has not looked at the problem.
Frequently asked questions
How long does it take?
Weeks where the entity already exists and we are adding medical direction and provider coverage. Longer where a new professional entity has to be formed, or where the state licenses clinics — Florida’s AHCA process, for example. We give you the real timeline before you sign anything.
Do we have to use your platform?
No. Medical direction and structure can be provided on their own. The platform matters when you need documented good faith exams at volume, which is most online and multi-site operators.
Can you cover states we are not in yet?
Yes — coverage is expanded state by state as you grow. That is the main reason operators use a network instead of hiring one physician.
Is this legal advice?
No. We build and staff the structure and keep the documentation current. Your attorney reviews it. Nothing on this site is legal advice, and requirements change.