AI drafts it.
A physician signs it.
Josh Emdur DO — 50-state licensed, BCH hospitalist since 2008 — reviews every LMN, CCM plan, and care document within 48 hours. $199 flat for your Letter of Medical Necessity.
"Telemedicine can be a front door to healthcare — connecting our society with medical professionals."
— Josh Emdur, DO Medical Director, Altru.care
Start your Letter of Medical Necessity
$199 flat. Physician-signed within 48 hours. HSA/FSA eligible.
How it works
AI handles the complexity. A physician provides the accountability.
Submit your intake
5 minutes, online. Tell us what you need — home care, wellness equipment, a care plan. No appointment required.
AI drafts your document
Clinical AI generates your Letter of Medical Necessity or care plan — same day. Medically precise. Ready for physician review.
Josh reviews and signs
Josh Emdur DO reviews, edits if needed, and signs within 48 hours. Delivered to your inbox. Valid for HSA/FSA submission nationwide.
Clinical Services
Three physician-reviewed services. All 50 states.
Letter of Medical Necessity
Unlock HSA/FSA eligibility for home care, wellness services, and medical equipment. $199 flat. Delivered in 48 hours. Physician-reviewed and signed in all 50 states.
Chronic Care Management
Ongoing physician oversight for Medicare patients with two or more chronic conditions. Monthly care coordination, medication reconciliation, 24/7 access. CCM billing covered by Medicare — most eligible patients pay $0 out of pocket.
Advance Care Planning
Document your wishes with physician support. A structured conversation that produces actionable advance directives — values, preferences, and instructions your family and care team can follow. ACP billing covered by Medicare.
Altru.care vs. telehealth vs. concierge
| Feature | Altru.care | Standard Telehealth | Concierge Practice |
|---|---|---|---|
| Can sign LMNs in your state | Yes — all 50 states | Depends on state | Local only |
| AI-drafted, physician-reviewed outputs | Yes — every document | No | Rarely |
| Chronic Care Management billing | Yes — Medicare covered | Varies | Rarely |
| LMN for HSA/FSA eligibility | Yes — $199 flat | Rarely offered | Sometimes |
| Advance care planning documentation | Yes — Medicare covered | No | Sometimes |
| Ongoing clinical relationship | Yes — not one-time visits | No | Yes |
Common questions
Can Josh sign LMNs in my state? ∨
Yes. Josh Emdur DO holds active medical licenses in all 50 states. An LMN signed by a licensed physician in your state is valid for HSA/FSA submission with your plan administrator. The $199 flat fee covers physician review, drafting, and signed PDF delivery within 48 hours. If Josh determines a letter is not medically appropriate, you pay nothing.
How is this different from regular telehealth? ∨
Standard telehealth is an on-demand visit. Altru.care is an ongoing clinical relationship. Josh manages chronic care over time, reviews AI-generated clinical outputs, and signs documentation (LMNs, CCM care plans, advance directives) that has lasting value. Most telehealth platforms cannot sign Letters of Medical Necessity or bill CCM codes because they lack the clinical infrastructure. Altru.care is built specifically for these services.
Does insurance cover this? ∨
It depends on the service. LMN is cash pay at $199 — but LMNs make your expenses HSA/FSA eligible, so you pay with pre-tax dollars. Chronic Care Management (CCM) is Medicare-covered; most eligible patients pay $0 out of pocket. Advance Care Planning (ACP) is also Medicare-covered. We'll clarify at intake which service fits your situation.
What is the turnaround time? ∨
Letters of Medical Necessity are delivered within 48 hours of intake. AI drafts your document the same day. Josh reviews, edits if needed, and signs — typically within 24–48 hours. CCM care plans and ACP documents follow the same same-day draft, 48-hour physician review cycle.
Peptide LMN Service
The same $199 physician-reviewed LMN infrastructure — now applying to legally compounded peptides as the regulatory window opens. FDA removed BPC-157, TB-500, KPV, and MOTS-c from Category 2 in April 2026. PCAC ruling expected July 2026; legal compounding window opens Q4 2026.
"We're building the attestation layer now. Be first in line when compounding opens."
Join the peptide LMN waitlist
No payment. No commitment. We'll notify you when the compounding window opens.
You're on the list. We'll reach out when the PCAC ruling lands.