Where a physician has to decide

This is not a discount engine.
It is a decision, and someone signs it.

Every category below turns on one clinical question: is there a diagnosed condition this actually treats? Answering it is the work — and the same answer, made once by a named physician, can carry pre-tax spend, a reimbursable service, and the care a family is already giving at home. A letter is only ever worth the physician behind it.

The categories

Nine places a Letter of Medical Necessity decides the sale.

Live means criteria are written and signed off, and cases are being taken today. Next means the structure exists and the medical director has yet to write the criteria — until then we do not offer it, because inventing criteria is exactly the failure this company exists to prevent.

Exercise therapy & supervised strength

LIVE · 9 CONDITIONS

Gyms, studios, coaching, physio-adjacent programming. The largest dual-purpose category and the one the IRS watches hardest.

What makes it real
GLP-1–associated muscle loss, osteoporosis, osteopenia, sarcopenia, type 2 diabetes, osteoarthritis, chronic low back pain, post-injury rehab, RED-S.
Anchor document
DEXA report, medication label, operative note, or a visit summary naming the diagnosis.
Partner shape
Membership or programme checkout. First customer: Kinesis Integrated.

Nutrition & food as medicine

NEXT

Medically tailored meals, dietitian programmes, therapeutic nutrition. Food is the clearest case of a dual-purpose expense: everyone eats, so the diagnosis carries the whole argument.

What makes it real
Type 2 diabetes, celiac disease, chronic kidney disease, diagnosed obesity, cardiovascular disease.
Anchor document
A recent lab, a clinician note, or a medication record naming the condition.
Partner shape
Subscription meal delivery, dietitian platforms, condition-specific programmes.

Sleep & apnea

NEXT

The cleanest diagnostic anchor of any category — a sleep study is an unambiguous document, and the equipment maps to the diagnosis without argument.

What makes it real
Obstructive sleep apnea, diagnosed insomnia, restless legs, circadian disorder under treatment.
Anchor document
Sleep study or the CPAP prescription itself.
Partner shape
Equipment and accessory brands, sleep clinics, CBT-I programmes.

Recovery, bracing & musculoskeletal devices

NEXT

TENS units, braces, compression, home traction. Some are already eligible without a letter; the value we add is telling a customer honestly which side of that line they are on.

What makes it real
A named orthopedic diagnosis or a post-surgical course under clinical guidance.
Anchor document
Imaging report, operative note, or PT referral.
Partner shape
DTC device brands, clinic retail, post-op kits.

Metabolic monitoring

NEXT

CGMs, connected scales, remote monitoring programmes. Adjacent to real reimbursement — the same attested record supports RTM billing on the clinical side.

What makes it real
Diabetes or prediabetes, metabolic syndrome, insulin resistance under management.
Anchor document
A1c or lipid panel, or the prescription record.
Partner shape
Monitoring subscriptions, metabolic health programmes.

Mental health & behavioural programmes

EXPLORATORY

Therapy platforms, digital CBT, substance-use programmes. Therapy from a licensed provider is usually eligible outright; the letter question is about apps, coaching and adjuncts — and the privacy bar here is higher than anywhere else.

What makes it real
A diagnosis from a treating clinician. We would never diagnose one.
Anchor document
Treating clinician's note, held by the person and never republished.
Partner shape
Digital therapeutics with an existing clinical relationship.

Women's health, fertility & postpartum

NEXT

Pelvic floor rehabilitation, postpartum recovery programmes, fertility tracking and treatment adjuncts. Under-served, heavily dual-purpose, and full of genuinely diagnosed conditions.

What makes it real
Pelvic floor dysfunction, diastasis recti, endometriosis, PCOS, diagnosed infertility.
Anchor document
OB/GYN or pelvic-floor PT note; imaging where it exists.
Partner shape
Programme subscriptions, device brands, clinic partnerships.

Respiratory & allergy home care

NEXT

Air purification, hypoallergenic bedding, dehumidifiers. The oldest letter category there is, and the one where partners most often over-promise blanket eligibility.

What makes it real
Asthma, allergic rhinitis, COPD, documented environmental allergy.
Anchor document
Allergy testing, a pulmonary note, or the controller-medication record.
Partner shape
Home-environment brands, allergy clinics.

Aging at home, mobility & caregiving

NEXT

Fall prevention, home modification, respite and companion care. The category where the person paying is almost never the person with the diagnosis — see below.

What makes it real
Fall risk with a documented history, mobility impairment, dementia diagnosis, post-hospital transition.
Anchor document
Discharge summary, PT evaluation, or a treating clinician's note.
Partner shape
co-op.care, home-modification providers, care agencies.
The family caregiver

The account holder and the patient are often two different people.

An HSA pays qualified expenses for the account holder, their spouse, and their tax dependents — which means an adult child can fund care for a parent who qualifies as a dependent, and a parent can fund care for a child. Nearly every product in this space assumes the buyer is the patient. The caregiver is the buyer far more often than the industry designs for.

Proxy intake, on the record

The caregiver answers on the patient's behalf and says so. The relationship is captured, the affirmations are signed as proxy, and the physician sees exactly who reported what. A letter written on a daughter's guesses, presented as her father's own account, is the kind of thing that unravels in an audit.

Licensed where the patient lives

Jurisdiction follows the patient, not the payer. A caregiver in Texas funding care for a parent in Ohio routes to a physician licensed in Ohio — the same rule as every other case, applied to the person receiving care.

One case, several expenses

One determination about one diagnosed condition can support the home modification, the mobility equipment and the companion hours that follow from it — each tied back to the same anchored record instead of three separate reviews.

The honest no matters more here

Families under strain are the easiest people to sell a bad letter to. A written no with a reason, at no cost, is the most protective thing this product does — and it is why we will not run this category on percentage-of-sale economics.

How we differ

Same idea as the incumbents. Different incentives.

Facilitating letters at checkout is not new. What decides whether the letters survive scrutiny is who signs them, how the reviewer is paid, and whether anyone outside the company can check the work.

 
ClinicalSwipe
The usual model
Who signs
An independent physician, NPI-bound, specialty-matched, licensed in the patient's state.
A network of licensed providers; credential and specialty are usually not shown to the customer.
How the reviewer is paid
A flat fee per determination, identical for a yes and a no.
Commonly bundled into a per-transaction or percentage arrangement tied to qualified sales.
Who pays it
The partner. $19 per determination, billed on the determination — the customer is never charged for the review, yes or no.
Typically funded out of the merchant's transaction economics, or charged to the customer.
What a no looks like
A written reason, on the customer's screen, at no cost, recorded like any other determination.
Often a silent non-approval with no artefact.
Can an outsider verify it
Yes. Every determination — signed or declined — posts a PHI-free hash to hashcare.com with the criteria version it was made under.
The letter is the only artefact, held in the vendor's account.
Criteria
Published, versioned, hash-anchored. Adding a condition requires the medical director's signature, not a product decision.
Internal, and revisable without a trace.
Where it goes next
The same engine attests any clinically meaningful AI output — prior authorization, remote monitoring, discharge documentation.
Purpose-built for the checkout letter.

The flat fee is the whole argument. A reviewer who earns more when approvals rise is the incentive an auditor looks for first; a reviewer paid the same either way has no reason to write a letter that is not true.

The larger thesis

Letters today. Every attested output tomorrow.

A Letter of Medical Necessity is one instance of a general problem: an AI system produces something clinically meaningful, and nobody's name is on it. Our physicians are not writing letters — they are attesting determinations, and a determination has many shapes.

Today

Eligibility determinations

Pre-tax spend across the categories above. One protocol, one receipt, one flat fee.

Adjacent

Prior authorization

The same packet-and-attestation shape, aimed at a payer instead of a plan administrator.

Adjacent

Remote monitoring & care documentation

An attested record is what makes monitoring billable; the physician's name is the billing requirement, not a formality.

The point

Physician judgment, scaled

One reviewer's decision, made once and anchored, can support several downstream expenses and reimbursements for the same person — including the care their family provides. See the full list →

What we won't do

Turn a category into blanket eligibility.

Being listed on this page does not make anyone eligible. The but-for test is per person: performance, general wellness, cosmetic weight loss without a diagnosis, and anti-aging are refusals we have written down so they cannot quietly drift into the offer.

Categories marked next have structure but no signed criteria. Until the medical director writes them, we do not take those cases — and no amount of partner demand changes that order. Final criteria await sign-off and no BAA is executed yet; pilots run on synthetic data until both clear.

Integration

One line, whatever you sell.

The pre-screen runs in your brand and hands the customers who might qualify to a physician. Same widget, same flat fee, whichever category you are in.

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