For nephrologists & primary care teams
Monitor your CKD patients
between every
appointment.
Daily blood pressure, weight trends, blood glucose, SpO2, and medication adherence - so your team catches fluid retention, BP spikes, and disease progression before they become hospitalizations.
HIPAA compliant · EHR integration · RPM billing eligible · Tenovi RPM devices included
Integrates with
EpicCernerathenahealtheClinicalWorksMEDITECHNextGen
Why continuous monitoring changes CKD outcomes
CKD progresses silently between visits.
Daily data shows what's actually happening.
Simple enrolment
From referral to monitored patient
in under a week.
Blood pressure monitoring and daily weight tracking start immediately. Tenovi RPM devices - BP monitor, weight scale, pulse oximeter, and glucose meter - ship to the patient pre-paired, no clinic visit needed.
1
Set monitoring parameters
Enter CKD stage, comorbidities (diabetes, hypertension), medication schedule, and alert thresholds. Select which Tenovi devices to ship. Under 3 minutes in the portal.
2
Devices ship, patient onboards via Ziva app
Tenovi BP monitor, weight scale, and pulse oximeter arrive pre-paired - no Bluetooth setup needed. Isabella walks the patient through their daily measurement routine and medication schedule.
3
Daily readings stream in automatically
Blood pressure, weight, SpO2, and blood glucose sync to Ziva automatically via cellular - no Wi-Fi, no app pairing needed each day. Your portal updates in real time.
4
Isabella flags deterioration patterns early
Rising BP combined with weight gain is a classic fluid retention pattern. Isabella correlates daily readings against each patient's baseline and alerts your team before the pattern escalates to an acute episode.
5
Monthly RPM report compiled automatically
BP trends, weight trajectory, medication adherence, eGFR context, and Isabella's clinical notes - auto-attached to your EHR before every visit. Supports RPM billing documentation for 99454, 99457, and 99458.
What Isabella tracks for CKD patients
🩸 Blood pressure — daily
Every reading timestamped via Tenovi Bluetooth BP cuff. Systolic and diastolic trends over 30 days. Alerts when consecutive readings exceed your set thresholds - e.g. SBP >140 for 3+ days.
⚖️ Weight & fluid retention
Daily weight via Tenovi smart scale. Rapid weight gain (e.g. +2 kg in 3 days) is a reliable early signal of fluid retention in CKD - Isabella flags this pattern and correlates with BP and SpO2 readings.
💊 Medication adherence
ACE inhibitors, ARBs, diuretics, phosphate binders, and other CKD medications tracked daily via the Ziva app or Tenovi smart pillbox. Missed doses flagged and correlated with BP escalation.
🩺 SpO2 & blood glucose
Pulse oximetry via Tenovi device - SpO2 drops can signal fluid congestion. For diabetic CKD patients, blood glucose monitored daily via Tenovi glucose meter, correlated with kidney function trajectory.
Robert M., 64* — CKD Stage 3
Fluid retention alert
Systolic BP — last 4 weeks
128
132
148
158
Wk 1–2: controlledThis week: 158/96 ⚠
BP today158/96 ↑
Weight change (5 days)+3.2 kg ↑
SpO294% ↓
ACE inhibitor adherence68% ↓
Routine days completed22 of 30 ✓
Isabella · Clinical summary
"Robert's pattern over the last 5 days is consistent with his prior fluid retention episode in March: BP escalating, weight up 3.2 kg, SpO2 dropping to 94%, and ACE inhibitor adherence below 70%. His last episode resolved with diuretic dose adjustment. Recommend same intervention now — or urgent contact to assess. 22 routine days — RPM 99454 eligible, 99457 management time applies."
Clinical dashboard
Catch fluid retention
before it becomes an admission.
Weight gain and rising blood pressure are the earliest reliable signals of fluid retention in CKD - but they're invisible between appointments. Ziva correlates daily BP and weight readings against each patient's personal baseline, alerting your team when the familiar pattern re-emerges.
✓Daily BP readings via Tenovi cuff — systolic and diastolic trend, consecutive-day alerts, 30-day average
✓Weight trend via Tenovi smart scale — rapid-gain alerts correlated with BP and SpO2 for fluid retention detection
✓Medication adherence — ACE inhibitors, ARBs, diuretics, and phosphate binders tracked daily, missed doses flagged
✓SpO2 monitoring via pulse oximeter — early signal of pulmonary congestion in advanced CKD
✓Blood glucose for diabetic CKD — daily readings, HbA1c context, correlated with BP and eGFR trajectory
✓Symptom logs — fatigue, swelling, shortness of breath, and nausea tracked daily and included in monthly report
*Stories are inspired by real patient experiences and health patterns observed in care. Names, images, quotes, and certain details have been changed or combined to protect privacy. Individual experiences and outcomes may vary.
Ready to monitor your CKD panel between appointments?
30-minute demo - BP dashboard, fluid retention alerts, RPM billing walkthrough.
RPM billing
CKD qualifies for RPM
under physiological monitoring codes.
Chronic kidney disease qualifies for Remote Physiological Monitoring under CPT 99454 (device supply, 16+ days). Daily blood pressure, weight, SpO2, and glucose readings are the qualifying physiological data transmissions. Clinician time reviewing data and communicating with patients generates 99457 and 99458.
Standard RPM — 16+ days / month
99453Initial setup & patient education (once)~$21 once
99454Device supply · 16+ days/month data transmission~$54/mo
99457Treatment management · first 20 min/month~$52/mo
99458Treatment management · each additional 20 min~$43/mo
CCM — for complex CKD with multiple comorbidities
99490Chronic care management · first 20 min/month~$63/mo
99439CCM add-on · each additional 20 min~$47/mo
Approximate Medicare rates. RPM and CCM can be billed together in certain circumstances. 99454 requires ≥16 days of data transmission per 30-day period. Consult your billing team for payer-specific requirements.
RPM revenue estimate
CKD patients on Ziva
25
5200
Billing mode
Device supply (99454)$1,350/mo
Treatment management (99457)$1,105/mo
Add-on management (99458)$538/mo
Monthly RPM revenue estimate
$2,993
$35,916 annually
What drives RPM day count for CKD
🩸
Daily BP reading
Each blood pressure reading from the Tenovi cuff is a cellular data transmission - the most reliable daily signal for CKD monitoring
⚖️
Daily weight measurement
Each smart scale reading syncs automatically via cellular - a second daily transmission qualifying toward 99454
🩺
SpO2 & glucose readings
Pulse oximetry and blood glucose transmit automatically each day - additional qualifying readings for high-engagement patients
Illustrative only. Approximate Medicare rates. Consult your billing team before go-live.
Book a demo
See Ziva in action with
your CKD panel.
30 minutes. BP and weight dashboard, fluid retention alert walkthrough, Tenovi device demo, RPM billing documentation, and a pilot design for your nephrology or primary care practice.
✓Live walkthrough of daily BP, weight, and SpO2 dashboard with fluid retention alert demo
✓Tenovi device demo — how the BP cuff, scale, and oximeter ship and sync without Wi-Fi
✓Monthly report format and RPM billing documentation walkthrough for 99454, 99457, 99458
✓EHR integration overview and pilot cohort design for your nephrology or primary care practice
Other conditions
Request a 30-minute demo
We'll walk through enrolment, alert configuration, and the revenue model for your practice.
Book my demo →No commitment. We'll follow up within 1–2 business days.
Questions
Provider FAQ
CKD qualifies for Remote Physiological Monitoring under CPT 99454 (device supply, 16+ days of data per month) and management codes 99457 (first 20 min) and 99458 (each additional 20 min). CPT 99453 is billed once for initial setup. For patients with multiple chronic conditions, CCM codes 99490 and 99439 may be billed alongside RPM. Consult your billing team for payer-specific documentation requirements and any payer-specific restrictions on concurrent billing.
Ziva uses Tenovi's cellular-enabled RPM devices: the Tenovi Bluetooth blood pressure monitor (connected via Tenovi hub), digital weight scale, pulse oximeter, and blood glucose meter for diabetic CKD patients. All devices transmit via the Tenovi cellular hub - no Wi-Fi, no smartphone app pairing needed on the patient side. Devices ship to the patient pre-configured and typically arrive ready to use out of the box.
Isabella correlates each patient's daily weight readings with blood pressure and SpO2 data to identify fluid retention signatures. The classic pattern - sustained weight gain of ≥2 kg over 3–5 days combined with rising BP and decreasing SpO2 - is flagged in real time. Isabella also builds a personalised baseline per patient, so alerts are calibrated to individual trends rather than generic thresholds. Medication adherence data for diuretics and ACE inhibitors is included in the alert context.
Yes - Ziva supports CKD Stage 1 through Stage 4. Monitoring parameters and alert thresholds can be customised per patient based on their stage, comorbidities (hypertension, diabetes, heart failure), and medication regimen. For Stage 5 patients on dialysis, Ziva supports symptom logging and medication adherence but is not a replacement for dialysis monitoring systems. Contact us to discuss your specific panel composition.
Yes - diabetic CKD is one of the most common presentations. When a patient has both conditions, Ziva monitors daily blood glucose via the Tenovi glucose meter alongside BP and weight. Isabella correlates glucose trends with kidney function context and flags patterns where poor glycaemic control may be accelerating CKD progression. The monthly report covers both conditions, supporting billing under both RPM (physiological) and, where applicable, diabetes-specific codes.
Yes. Fully HIPAA compliant, BAA available. All PHI encrypted in transit and at rest. US data residency. Security documentation and DPA available for your compliance team.