Services
Online follow-up visit
An online follow-up visit has a published price and is a shorter video visit with Dr. Diana Nieves Castro, a Puerto Rico-licensed physician, for two things: a refill of a medicine you already take (non-controlled), which anyone can book, and a review of lab results from an earlier visit, which is for existing patients only. If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
Is it an emergency? Call 911.
Pay now, then choose your time right away. Full refund if you cancel 24 hours or more ahead.
See the cancellation policy
You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.
If you choose a time less than 24 hours away, it can't be cancelled or changed.
If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.
Is this an emergency?
This is not an emergency service. Call 911 or go to the nearest emergency room if you have:
- Chest pain or pressure, or trouble breathing
- A drooping face, weakness on one side or trouble speaking
- Very high blood pressure with a severe headache, confusion or vision changes
- Low blood sugar that isn't improving, or confusion or fainting
Help lines
On this page(9)
What an online follow-up visit is
It's a more focused video visit than a full doctor visit, for when you already know what you need: to keep taking your medicine or to understand your results. You see the same doctor, Dr. Diana Nieves Castro, MD, a general practice physician with several years of emergency-department experience.
It covers two things:
- A [review of your lab results](route:guide-lab-results). For existing patients only, with results from tests the doctor ordered at an earlier visit.
- A refill of a medicine you already take (non-controlled). Anyone can book it. A controlled medicine needs a doctor visit, where the doctor decides what is appropriate. If you only need to renew a medicine, read prescription refills.
Before you leave home
Why a video visit
For anything that isn’t an emergency, compare what each option takes.
| Comparison | Video visit | Emergency room | CDT or doctor’s office |
|---|---|---|---|
| Getting there | From home: join from your phone, tablet or computer. | Drive and find parking. | Drive and find parking. |
| Waiting room | Skip the waiting room: join from wherever you are in Puerto Rico. | Yes, a waiting room. | Yes, a waiting room. |
| Hours and time | Every day, any time (Puerto Rico time). Video doctor visits 24/7 — book online and choose your time right away. | In Puerto Rico, a median of 4 h 52 min from arrival to departure for patients sent home (US: 2 h 42 min; Oct 2024–Sep 2025).1,2 | An in-person visit takes about 2 hours on average, including travel.3 |
| Price | US$79 visit · US$49 follow-up · US$35 forms. You see it before you pay; no insurance needed. | Depends on your insurance and on what is done. | Depends on your insurance and on what is done. |
| Language | Spanish or English, with the same doctor. | Depends on the place. | Depends on the place. |
| Prescriptions | If appropriate, the doctor prescribes and we send your prescription to your pharmacy. | Yes, if needed. | Yes, if needed. |
| When to go in person | If the doctor needs to examine you in person or run a test, she tells you and guides you. | In an emergency: chest pain, trouble breathing, weakness on one side or bleeding that won’t stop. Call 911. | If you need stitches, an X-ray or a test on the spot. |
For problems that are not emergencies. In an emergency, call 911.
Table sources
- 1. CMS Care Compare, “Timely and Effective Care – State”, measure OP-18b: median time in the emergency department, arrival to departure, for patients sent home (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
- 2. CMS Care Compare, “Timely and Effective Care – National”, measure OP-18b (US figure) (opens in a new tab), data for Oct 2024–Sep 2025 (accessed 2026-10-02)
- 3. Ray KN et al., “Opportunity costs of ambulatory medical care in the United States,” Am J Manag Care 2015;21(8):567-74 (US data, 2003–2010) (opens in a new tab) (accessed 2026-10-02)
We found no published source for what a patient pays at an ER or a CDT in Puerto Rico, so we give no figure.
How a results review works by video
Before the visit, get your results from the lab and jot down your questions: which value came back high or low, whether a test needs repeating, or what has changed since last time.
During the visit, the doctor walks you through each value in plain language, what it means for you and what comes next: stay the course, adjust treatment or run another test. Have your results with you, on paper or on your phone.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
Your doctor
Dr. Diana Nieves Castro, MD
General practice physician
Several years of emergency-department experience.
Founding Executive Director of The Health Initiative.
Your follow-up in 3 steps
Video doctor visits 24/7 — book online and choose your time right away.
Request your visit, choose Follow-up visit and pay by card.
You are charged when you request it, with a full refund if the clinic can’t see you.
You choose your time when you book, and we send your secure video link.
It works on your phone, tablet or computer.
Talk with the doctor by video
about your results or your medicine, and leave with clear next steps.
Price:, and when it becomes a full visit
A follow-up visit has the same price for every age, with no membership. A doctor's note after your visit, if you need one, is included.
Sometimes a follow-up turns out to need a full doctor visit: for example, if you have a new symptom, the medicine isn't working, or your results show something that needs a full evaluation. In that case the doctor explains why and, only with your consent, you pay the difference between the two visits. We never charge the difference without your agreement.
Video visit
Follow-up visit
US$49
A refill of a medicine you already take (non-controlled) and a review of lab results from a previous visit.
- You’re charged when you request the visit.
- Full refund if the clinic can’t see you
Who can book a follow-up visit
It depends on what you need:
- A refill: anyone who already takes the medicine, even if we've never seen you.
- A results review: existing patients only, with results from tests the doctor ordered.
- Results another doctor ordered, or a new problem: choose a doctor visit so the doctor can evaluate you fully.
- Ongoing conditions such as high blood pressure or diabetes: see chronic care too.
What happens after your results review
Depending on your results, the doctor may adjust your treatment, give you a new lab order to repeat or complete a test, or recommend an in-person visit or a specialist. She tells you what to do and when to check in again.
When to go to the ER
A follow-up visit is not for emergencies. If you have chest pain, trouble breathing, signs of a stroke, a very high blood pressure reading with a severe headache or vision changes, or signs of low blood sugar that aren't improving, call 911.
Book your follow-up visit
Book a visit and choose Follow-up visit. For a new problem, choose Doctor visit. For a patient under 21, a parent with patria potestad (parental authority) or a legal guardian must stay on camera for the whole visit.
How we care for you
We evaluate, diagnose and treat; if needed, we give you a lab order for a lab near you.
We see adults and children of all ages. Patients under 21: a parent with patria potestad (parental authority) or a legal guardian is on camera for the whole visit and shows photo ID.
Real-time video visit. We send you a secure video link. It works on your phone, tablet or computer.
If appropriate, the doctor prescribes and we send your prescription to your pharmacy.
You must be physically in Puerto Rico during the visit (visitors, tourists and cruise passengers are welcome).
In an emergency, call 911.
Frequently asked questions
Can I book a follow-up visit if I've never been seen?
Will you review lab results another doctor ordered?
What if my follow-up needs more than a follow-up?
What should I have ready for my results review?
Before you pay
Why do I pay before choosing a time?
Can I cancel or change the time?
Do you record the visit?
Need a refill or a results review?
US$49Follow-up visit
- You’re charged when you request the visit.
- Full refund if the clinic can’t see you
Video doctor visits 24/7 — book online and choose your time right away.
Follow-up visit: US$49 — BookPay now, then choose your time right away. Full refund if you cancel 24 hours or more ahead.
See the cancellation policy
You can cancel for a full refund or change the time up to 24 hours before your visit. Within 24 hours you can't cancel and there's no refund. If you don't join in the first 10 minutes, there's no refund.
If you choose a time less than 24 hours away, it can't be cancelled or changed.
If the clinic can't see you, for example because of a technical problem on our side, we refund you in full.
About this page
Author: The Health Initiative
Medical care provided by Dr. Diana Nieves Castro, MD (PR license 24027)
Disclosure: Founding Executive Director of The Health Initiative
Published: 2026-09-30 · Updated: 2026-10-11
Sources (5)
- Lab tests (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-09-30)
- Stroke signs and symptoms (CDC) (opens in a new tab) (accessed 2026-09-30)
- Malignant hypertension (MedlinePlus, NIH) (opens in a new tab) (accessed 2026-09-30)
- CDC: Low blood sugar (hypoglycemia) (opens in a new tab) (accessed 2026-09-30)
- Puerto Rico Telemedicine and Telehealth Act, Ley 168-2018 (LexJuris, Spanish) (opens in a new tab) (accessed 2026-09-30)