The turnkey telehealth launcher market is crowded, and the pitch sounds the same everywhere: launch your own GLP-1 or peptide brand in 48 hours, no medical license required, everything handled for you.
Some platforms actually deliver on that. Others have fee structures built to extract margin at every layer, technology held together by subcontractors you have never heard of, and contract terms that leave you with nothing if you ever try to leave.
The difference does not show up on a homepage. It shows up when you ask the right questions before you sign anything.
These are the 13 questions worth asking.
Before You Ask Anything Else: Get the Actual Contract
Every platform will walk you through a sales deck. None of it is binding. Before you go deep on any of the questions below, request a draft service agreement, a draft Business Associate Agreement (BAA), and a complete written fee schedule. If they hesitate to share these before you sign, that tells you everything you need to know.
Question 1: Whose name shows up on your patient’s credit card statement?
Ask any platform this question and watch what happens. The answer tells you who actually controls your revenue.
When a patient pays for their program, the entity that processes that transaction is called the merchant of record. It holds the legal relationship with the payment processor, assumes chargeback liability, and controls what happens when a patient disputes a charge. On many turnkey platforms, the platform is the merchant of record, not you.
That arrangement has real consequences:
- The platform controls refunds and dispute resolution, not you
- If the platform terminates your account, your payment infrastructure disappears with it
- Your patients’ receipts and statements show the platform’s name, not yours
- Your revenue can be held or frozen at the platform’s discretion
Being the merchant of record yourself means you control your revenue, your chargebacks, and the payment relationship with your patients. If a platform will not give you that, make sure you understand exactly what you are agreeing to before you sign.
What to ask: “Who is the merchant of record for patient payments? Whose name appears on the patient’s credit card statement? What happens to my recurring subscriptions if our relationship ends?”
Question 2: Do you own your domain, brand name, and all creative assets - and are they hosted somewhere you control?
This is where operators get burned more often than any other issue. They build a brand, grow an audience, and then discover they do not actually own the infrastructure underneath it.
The domain ownership problem gets most of the attention, but the hosting problem is just as dangerous. Many platforms host your intake flow and patient-facing website on their own servers, under their own accounts. If you decide to leave, or if they decide to remove you, your entire web presence goes dark. You have no site, no intake flow, and no way to take patients in while you scramble to rebuild somewhere else. That is not leverage - that is a hostage situation.
Before you launch, confirm in writing:
- The domain is registered in your name and in your registrar account, not the platform’s
- Your website and intake flow are either hosted on infrastructure you control, or you have a clear contractual right to migrate them with no blackout period
- Your brand name, logo, and creative assets belong to you and cannot be used or withheld by the platform
- There is no scenario where the platform can take your site offline as a consequence of a billing dispute or contract termination
What to ask: “Who owns the domain and who controls the hosting account? If I leave or you terminate my account tomorrow, what happens to my website and intake flow? How long until it goes dark?”
Question 3: Do you own the patient and marketing relationship?
Your patient list is the asset you are building. Whether that asset is actually yours depends on what the contract says.
This breaks into two distinct layers:
The marketing relationship. Your email list, SMS subscribers, and customer contact data should be yours. But some platforms retain the right to market to your patients, restrict your ability to move them to a different platform, or impose non-solicitation periods after you leave.
The clinical relationship. Patient medical records may legally belong to the professional corporation that employed the treating provider, which is typically a platform-controlled entity. This can complicate what you are allowed to do with those records if you exit.
Both matter. Ask directly.
What to ask: “Who owns the patient contact list? Who owns the medical records under your corporate structure? If I leave, can I contact my patients about their care and market to them with no restriction?”
Question 4: Is pharmacy pricing pass-through?
Pharmacy costs are one of the largest line items in any GLP-1 or peptide program. The question is whether you pay the actual compounding pharmacy price, or whether the platform adds a margin on top.
Pass-through pricing means you pay exactly what the pharmacy charges. The platform makes money on the platform fee, not on your medication costs.
Marked-up pricing means the platform buys from the pharmacy at one price and charges you more. This spread is often not disclosed in the headline pricing, and it compresses your margin in a way that is hard to see until you are several months in.
Ask the specific numbers, not a general answer.
What to ask: “Is your pharmacy pricing pass-through, or do you add a markup? What does the pharmacy charge you per unit for [specific medication], and what do you charge me?”
Question 5: Is provider network pricing pass-through?
The same question applies to clinical review costs. Every time a patient intake reaches a provider for review, there is a cost. Whether you pay the actual provider rate or a marked-up platform rate is a question most operators never think to ask.
Some platforms contract with providers at one rate and charge partners a higher rate per review. That spread is invisible unless you dig for it.
What to ask: “What does a provider review cost you, and what do you charge me per review? Is there a markup on provider services?”
Question 6: Did they clearly lay out every cost and model your revenue with you?
This is a character test as much as a financial question.
A platform confident in its own model will sit down with you, use real numbers, and show you what the economics look like at 10 patients, 50 patients, and 200 patients. That means actual revenue, actual pharmacy costs, actual platform fees, actual payment processing rates, and a realistic margin per patient at each level.
A complete cost disclosure covers:
- Setup fees
- Monthly platform fees
- Per-case or per-consultation fees
- Pharmacy costs (pass-through or marked up)
- Payment processing rates
- Chargeback handling
- Revenue share percentage, if any
If a platform focuses on revenue potential without ever modeling the full cost picture, or builds a forecast around a price point the market will not support, they are not being straight with you. Ask them to do the math on a call, with their real numbers. If they resist that exercise, that is an answer.
What to ask: “Let’s model the economics right now. Using your actual fees and a realistic patient price, what is my gross margin per patient at 25 active patients? At 100?”
Question 7: Who legally owns the medical practice, and what does the corporate structure look like?
Most states have corporate practice of medicine (CPOM) laws that prohibit non-licensed individuals from owning or controlling a medical practice. A compliant turnkey platform separates two entities to handle this:
- Management services organization (MSO): Your business entity. Handles everything non-clinical: marketing, technology, billing, operations.
- Professional corporation (PC): A licensed medical entity, owned by a licensed physician, that employs or contracts the providers and owns the clinical relationships.
You contract with the MSO. The PC handles the clinical side.
If a platform cannot clearly explain this structure, or cannot describe how it maps to the specific states where you want to operate, your entire program may be considered unlicensed practice of medicine. Ask to see the structure in writing and have your own attorney review it before you commit.
What to ask: “Walk me through your corporate structure. Who owns the PC? Where is it incorporated? How does this apply in the states I plan to operate in?”
Question 8: How is payment processing handled, and will they help you get LegitScript certified?
Payment processing for prescription medication programs is not as simple as setting up Stripe. Most standard payment processors restrict or prohibit these transactions outright. A GLP-1 or peptide program running on the wrong payment stack is one flagged transaction away from a frozen account and no revenue.
But here is what most platforms will not tell you upfront: most compliant payment processors for healthcare also require LegitScript certification before they will approve your merchant account. So LegitScript is not just an advertising requirement - it is a payment processing requirement.
That creates a revealing situation. If the platform is the merchant of record, they hold the LegitScript certification - not you. You are running under their certification. When you leave, you do not take it with you. You start over: blocked from running ads and potentially unable to open a compliant merchant account until you go through the full certification process in your own name.
So if a platform has never mentioned LegitScript, or cannot help you get certified in your own name, there is a strong chance they intend to stay the merchant of record. That is your first question and this one colliding.
Beyond payment processing, Google, Meta, and most major ad platforms require LegitScript certification to approve ads for prescription medications. No certification means no paid advertising at scale.
The certification process requires documentation of your pharmacy relationships, provider network coverage, compliance policies, and telehealth infrastructure. A platform that has helped partners through it can make a significant difference in how quickly you get certified and how smoothly your ads go live.
What to ask: “Am I getting my own LegitScript certification, or am I operating under yours? Have you helped other partners get certified in their own name? What payment processor do you use, and what are the requirements for opening my own merchant account?”
Question 9: What compounding pharmacy do you work with, and how do you verify they are legitimate?
This question is also a test.
In a direct-to-patient telehealth model, your pharmacy ships medication directly to the patient’s door. That means you need a 503A compounding pharmacy - a state-licensed pharmacy that compounds medications based on individual patient prescriptions and ships directly to patients.
503B outsourcing facilities cannot do this. They are FDA-registered batch manufacturers that ship to licensed practitioners and healthcare facilities for office use or in-office administration - not to patients at home. If a platform tells you they use a 503B pharmacy that ships direct to your patients, they either do not understand the regulatory framework or are misrepresenting how their supply chain works. Either way, it is a red flag.
So the right question is not “are you 503A or 503B?” It is: which 503A pharmacies do you work with, and how do you verify their quality?
For 503A pharmacies, the key due diligence questions are:
- Which states are they licensed to ship to? (503A pharmacies must hold non-resident pharmacy licenses in each state they ship to)
- Do they provide certificates of analysis (COAs) for every batch?
- Are they PCAB-accredited (voluntary quality certification)?
- What is their track record with state pharmacy board inspections?
Ask for the actual pharmacy name, then verify their state licensing and inspection history yourself through the relevant state pharmacy board.
What to ask: “Which pharmacy ships directly to my patients? Which states are they licensed to ship to today? Can you show me a sample COA for [specific medication]?”
For a detailed breakdown of pharmacy types, read our 503A vs 503B pharmacy guide.
Question 10: What happens if the FDA removes semaglutide or tirzepatide from the shortage list?
Compounding pharmacies can legally produce semaglutide and tirzepatide only because these active ingredients are on the FDA’s drug shortage list. When they come off that list, compounding stops. The grace period is limited.
The FDA has already moved in this direction. Any platform that treats this as a non-issue is either not tracking the regulatory environment or not being honest with you.
A platform with a real contingency plan will tell you specifically: what brand-name access they have, what alternative weight loss programs are available, and what the patient migration protocol looks like if compounding stops.
What to ask: “If the FDA removes semaglutide or tirzepatide from the shortage list next month, what is the patient communication plan and what do we pivot to?”
Question 11: Who handles adverse events, complaints, and state medical board inquiries?
This is the question that reveals whether you have a real partner or just a vendor.
When a patient has a bad reaction, files a complaint, or when a state medical board opens an inquiry, someone has to respond. Operators who assume the platform absorbs all of this are sometimes surprised to find their name on the complaint.
Ask for the documented process, not a general reassurance. Who is the named party in a patient complaint? Who responds to a state medical board? What is the protocol when a patient’s clinical situation goes beyond what the platform’s standard workflow handles?
What to ask: “Show me the adverse event and complaint SOP. Who is the named party if a state medical board contacts you about one of my patients?”
Question 12: Does the platform have proprietary technology, or are you working through subcontractors?
Many turnkey platforms are assemblers, not builders. They have packaged several third-party tools (a generic EMR, a third-party intake builder, an outsourced provider network) under one agreement and called it a platform. That is not automatically a problem, but it creates real risks:
- If a vendor raises its prices, your fees go up
- When something breaks, the platform may be waiting on a third party to fix it
- If an underlying vendor shuts down or has an outage, it affects your program
- If the EMR is a third-party tool, your records are subject to that vendor’s data portability terms, not just the platform’s
Ask specifically about the EMR, intake flow, provider network, and pharmacy integration layer. For each: built in-house, or a third-party product?
What to ask: “Which parts of your platform are proprietary versus third-party tools? Who built the EMR? What happens to my program if one of your subcontractors goes down or shuts down?”
Question 13: What does the offboarding process actually look like?
Platforms describe onboarding in detail. Almost none describe offboarding. That gap is intentional.
A fair exit includes a full data export of all patient records and prescription history in a portable format (not a locked PDF), your complete patient contact list, a defined transition timeline for active patients, and no exit fees or non-solicitation clauses restricting what you do next.
Ask for the offboarding terms in the service agreement before you sign. If they are not there, ask for them to be added. A platform that is willing to clearly define a fair exit process is showing you something real about how they operate.
What to ask: “Walk me through offboarding. Where is it documented in the service agreement, what data do I receive, and are there any restrictions on what I do with my patients after I leave?”
Putting It Together
A platform that cannot clearly answer these 13 questions is showing you exactly what the working relationship will be like. The ones worth trusting will have specific, written answers to every one of them.
Ask every question before you sign anything, spend money on ads, or bring patients into infrastructure you do not fully understand.
At Karpa Health, we built the platform to answer every one of these questions directly. Pharmacy and provider network pricing is pass-through. Partners own their domain, brand assets, and patient relationships. The fee structure is in writing before you commit to anything. And we have worked with partners through LegitScript certification.
If you are evaluating platforms and want to see how Karpa stacks up, book a call with our team. We will walk through every line item with you.
