Review LMNs on your schedule.

Async telehealth work for licensed MDs, DOs, NPs, and PAs. Patients submit a structured questionnaire. You review, sign, or decline. Most LMNs take 4-7 minutes. We pay $50-80 per review. You see the full audit trail of every LMN you've touched.

What this is

Canary is a marketplace for environmental health testing in the home — mold, lead, water quality, allergens, VOCs. Patients with diagnosed allergic, respiratory, dermatologic, or gastrointestinal conditions book inspectors to sample their home. To pay with HSA / FSA, the IRS (under Publication 502) requires the testing be medically necessary for the diagnosis, cure, mitigation, or treatment of disease, and that necessity be documented in a Letter of Medical Necessity signed by a licensed clinician.

You're that clinician. You're not taking on care of the patient. You're documenting medical necessity for reimbursement, on the basis of structured information the patient provides and a defined indication set.

How a review goes

1. The patient completes a six-field questionnaire (diagnosis being investigated, symptoms, symptom duration, current medications, optional home description, reason for testing).
2. The case lands in your queue. PHI fields are decrypted only for you; the patient's address is redacted; the inspector's identity is not visible.
3. You read. You either sign the LMN — using a state-aware template Canary maintains against IRS Publication 502 criteria — or decline with a stated reason.
4. The patient is notified. The signed LMN attaches to their booking; if you declined, the patient may revise + resubmit or pay out of pocket.
5. The LMN review fee transfers to your Stripe Connect account on a weekly schedule.

What we ask

• Current license in at least one US state where you accept LMN reviews. Multistate compact welcome.
• NPI verification. We verify your NPI against the NPPES public registry at onboarding. The name on your NPI must match your profile.
• State scope respected. NPs in restricted- practice states route through a senior physician co-sign workflow. We don't ask any clinician to sign outside their licensed scope.
• BAA signed at onboarding. Standard form.
• HIPAA training acknowledgment. We provide a 25-minute module if you don't already have a current cert.
• Multi-factor authentication. TOTP via Authy / Google Authenticator / 1Password. Required for clinical roles; not optional.
• Honest declines. If a case isn't a clear medical indication, decline. We don't pressure volume. Declines are part of the audit log just like signs.

What you'll see on a case

A 200-300 word block from the patient describing: the diagnosis their treating clinician has given them or that their treating clinician is investigating; symptoms (with specifics); duration; current medications; the home environment (age, type, water history, pets, recent renovations); and what they're hoping to learn.

You'll also see the service the patient booked (e.g. "Mold + IAQ panel, scheduled 2026-06-14, Boston MA") and the pre-built LMN template populated with the patient's information.

You will not see: the patient's street address; the identity of the matched inspector; the patient's payment information; any prior LMN history except what the patient themselves entered.

What we won't ask you to do

• Make a medical diagnosis (the LMN documents medical necessity for a stated indication; it doesn't diagnose).
• Prescribe medications.
• Sign for indications outside mainstream environmental medicine literature (we have a list of indications-in-scope and we keep it short on purpose).
• Maintain ongoing care of the patient. The LMN is one episode of documentation.
• Work outside your state scope.

Indications in scope (as of 2026-05-29)

• Diagnosed allergic rhinitis or asthma with suspected environmental trigger (per AAAAI / NHLBI / GINA).
• Chronic sinusitis with environmental component.
• Atopic dermatitis with home environment suspected.
• Recurrent ear / throat infections in children.
• Elevated blood lead level (clinical concern for source).
• Suspected PFAS exposure from contaminated drinking water.
• Pre-purchase / pre-pregnancy environmental due diligence with relevant clinical history.

This list is reviewed quarterly by Canary's clinical advisory board. If a case in your queue doesn't map to one of these, decline. We may expand the list with peer-reviewed support; we will never expand it for marketing reasons.

Compensation

• Standard LMN review: $50.
• Complex LMN (longer questionnaire, multi-service): $80.
• Stripe Connect, weekly payouts.

We don't pay per attempt — only per signed or declined LMN. A decline counts as a completed review.

How we protect you

• Full audit log of every case you touched. Exported on demand. If a board ever asks, you have the chronology.
• MFA required. No password-only access for providers.
• Idle timeout: 10 minutes. You won't leave a session open by accident on a shared device.
• State-scope guardrails. Cases outside your licensed states or scope don't reach your queue.
• You retain the right to decline at any point. No volume pressure, no "preferred provider" tiers.

Apply

Create a provider account — onboarding walks through NPI verification, BAA, MFA enrollment, and HIPAA training. Or email providers@canary.health with questions. We respond within two business days.