Who this is for
Hospital executives, clinical leaders, and admin teams. Read it together. The goal is to agree on what you need now and where you're heading next, before you talk to any vendor.
Step 1: Design the program first
Most hospitals start by shopping for a vendor. Start instead by sorting your specialist needs into layers. Each layer has a different tool and a different cost. Simple questions should never pay complex-patient prices.
Quick questions
Free AI first. Human curbside as backup.NowHospitals used to pay for reference subscriptions to answer everyday questions. Today, free AI tools give a good first answer to most of them in seconds. Make AI the first stop. When the answer isn't clear, or the stakes are higher, a human specialist curbside is the backup.
Most consults
eConsultNowA specialist reviews the chart and writes an official consult note. No visit, no transfer, no waiting weeks. The VA has used eConsults across its system since 2011, and it works. Most inpatient and outpatient consult questions fit here.
Complex patients
Tele-clinic or inpatient tele-consultNowSome patients need a specialist to see them. Outpatients go to a scheduled tele-clinic. Inpatients get a telemedicine consult at the bedside, with the note in your chart.
Emergencies, 24/7
Tele-stroke, tele-ICU (eICU)NextSome needs can't wait for a schedule. Tele-stroke and tele-ICU give you a specialist around the clock for time-critical calls. This is usually the next step once layers 1–3 run well.
Think of it as a ladder. Push each question to the lowest layer that can safely answer it. That keeps patients in your hospital, keeps specialists for the cases that need them, and keeps cost in line.
Step 2: Build the business case
Each leader looks at it a little differently. Answer all three:
- Executives: How many transfers and outside referrals do we send out each month? What revenue and patient days leave with them?
- Clinical leaders: Where do our clinicians get stuck waiting for a specialist? Which cases would they keep with the right backup?
- Admin and finance: What do we spend today on locums, call pay, reference subscriptions, and transfers? Which costs are fixed, and which can follow volume?
Then plan for the future, not just today. Pay for what's working now (layers 1–3) and set a date to look at 24/7 programs once you have the data.
Step 3: What each plan covers
Here's how Beam's plans line up with the layers. There are no per-provider fees.
Curbside
$100 / mo
Billed annually ($1,200 / yr) · + $49 per question
Quick questions to many specialties, through the app.
eConsult
$200 / mo per specialty
Billed annually ($2,400 / yr per specialty) · + $149 per consult
Official specialist consult notes, through the app.
Tele-Case Management
$1,200 / mo
Billed annually ($14,400 / yr) · + $25 per consult
A case manager on call for your hospital, every day.
Tele-Clinic
$6,500 / mo per specialty
Billed monthly · Starts at one half-day clinic
A scheduled specialist clinic for your patients.
Inpatient tele-consults, tele-stroke, and tele-ICU are scoped to your hospital. Talk to us for a quote.
Step 4: Pick the partner
Only now talk to vendors. Ask every one of them these five questions:
- 1
What accreditation do you hold?
Look for a recognized accrediting body, such as The Joint Commission. Ask for proof, not a logo.
- 2
Do you employ your own clinicians?
A core team that knows your hospital beats a rotating gig roster. Ask how many clinicians are employed versus contracted.
- 3
Do you carry your own malpractice?
Your partner should cover its own clinicians. Ask for the certificate and the limits.
- 4
What clinical and admin references can you give?
Ask for both: a physician leader and an administrator at a hospital like yours. Call them.
- 5
Do you deliver the service yourselves, or use third parties?
Some vendors resell other groups' clinicians. Ask who actually answers the call and writes the note.
Want help mapping your layers?
We'll walk your team through what to run now and what to plan for next.
See hospital solutionsFrequently asked
What should a hospital do first when building a telehealth program?
Design the program before picking a partner. Sort your specialist needs into layers: quick questions, routine consults, complex patients, and emergencies. Each layer needs a different tool and a different price.
Can free AI tools replace curbside questions?
For many quick, general questions, free AI tools now give a good first answer. They don't replace clinical judgment. Keep a human curbside as backup for the questions AI can't settle.
Can most specialty consults really be done by eConsult?
Many can. The VA has run eConsults across its system since 2011. A specialist reviews the chart and writes an official note, often without the patient ever needing a visit.
What questions should we ask a telehealth partner?
Ask what accreditation they hold, whether they employ their own clinicians, whether they carry their own malpractice, what clinical and admin references they can give, and whether they deliver the service themselves or hand it to third parties.
References
- 1.U.S. Department of Veterans Affairs. VA eConsult program overview and evaluation. VA Health Services Research & Development. https://www.hsrd.research.va.gov/
- 2.California Telehealth Resource Center. 20 Questions to Ask a Specialty Service Provider. 2021. https://caltrc.org/get-started/20-questions-to-ask-a-specialty-service-provider/
- 3.MUSC Telehealth Center of Excellence & Manatt Health. Transforming Rural Hospitals Through Telehealth Partnerships: Strategic Playbook. 2026. https://telehealthcoe.org/wp-content/uploads/2026/01/MUSC-Telehealth-Rural-Hospital-Playbook_2026-01_c.pdf
This article is for general educational purposes only and is not medical, legal, billing, or coding advice. Reimbursement rules and amounts vary by payer, state, and year — confirm with a qualified billing professional and your payer's current policy before acting on anything here.
See how Beam approaches this in practice
Beam runs same-day specialist consults documented in the chart. The fit depends on your setting and payer mix — happy to walk through it.