For clinicians & care teams
Manage your perimenopause
patients between every
appointment.
Skin temperature hot flash detection, HRV and sleep monitoring, HRT adherence tracking, symptom tags, and monthly reports - so your team sees the objective picture before every visit, not just a hormone result every few months.
HIPAA compliant · EHR integration · RTM billing eligible · No chronic disease requirement · Setup in weeks
Integrates with
EpicCernerathenahealtheClinicalWorksMEDITECH+ more
Why continuous perimenopause monitoring changes outcomes
A hormone result every few months is one number.
Daily wearable data is the story behind it.
Simple enrolment
From referral to monitored patient
in under a week.
Wearable connection is optional but powerful - Ziva's core value starts immediately with HRT adherence tracking, symptom tags, and daily routines. Isabella onboards the patient entirely.
1
Refer and set clinical parameters
Set HRT type, dose, administration schedule, lab order interval (FSH, estradiol, LH). Enter current labs if available. Under 3 minutes.
2
Patient onboards via the Ziva app
Isabella walks the patient through their daily routine - HRT logging, symptom tags, and wearable connection if available. Smartphone only.
3
Wearable data streams to your dashboard
Skin temperature spikes, HRV, sleep fragmentation, and resting heart rate populate the patient panel daily - automatic, no patient logging required.
4
Symptom tags logged by the patient
Hot flash events, night sweats, mood changes, and brain fog are tagged in real time. Timestamped, counted, and correlated with wearable signals automatically.
5
Labs entered — Isabella correlates
FSH, estradiol, LH, and progesterone results entered by patient or provider. Isabella overlays each result on symptom burden and HRV history - the relationship between labs and how the patient felt becomes visible.
6
Monthly RTM report compiled automatically
Hot flash frequency, HRV trend, sleep quality, HRT adherence, lab trend, and symptom tags - compiled and ready in the portal and EHR before every visit. Supports RTM billing documentation.
What Isabella tracks for perimenopause patients
🌡 Skin temperature · hot flash detection
Temperature spikes from Apple Watch or Oura Ring - frequency, duration, and time of day. The first objective hot flash signal in a clinical workflow.
⌚ HRV, sleep & resting heart rate
Wearable signals streamed automatically - HRV decline, sleep fragmentation from night sweats, and resting HR trends. No patient logging required.
🏷 Symptom tags
Hot flashes, night sweats, mood changes, brain fog, and joint pain - tagged by the patient as they occur. Timestamped, counted, and correlated with wearable data.
💊 HRT adherence & timing
Every dose, patch change, or gel application timestamped. HRT adherence pattern visible monthly - correlated with symptom burden and lab results.
HRT forms supported
Oral tablets, transdermal patches, topical gels, vaginal rings, and combination regimens - all tracked with provider-set schedule and dose. Progesterone co-administration also logged separately.
Sandra K., 48* — Perimenopause panel
Review needed
Skin temp spikes — last 4 weeks · Apple Watch
12×
4w ago · 3 spikesThis week · 12 spikes
HRV trend · Apple Watch
34ms
Down from 58ms 3 weeks ago · sleep fragmented 8 of last 10 nights
Last FSH / estradiolDue for recheck
HRT adherence this month78%
Hot flash tags this week12 occasions
Avg sleep efficiency61% ↓
Isabella · Clinical summary
"Sandra's skin temperature spikes have increased from 3 to 12 per week over 4 weeks — consistent with worsening hot flash burden. HRV has declined from 58ms to 34ms over the same period, and sleep efficiency is at 61%. 78% HRT adherence — review whether patch day is being missed consistently. Labs due: order FSH and estradiol to assess whether dose adjustment is needed."
Clinical dashboard
See hot flash burden,
HRV, and HRT adherence together.
A hormone result every 3–6 months tells you almost nothing about how your patient is living with perimenopause. Ziva gives you the continuous picture - objective skin temperature data, HRV and sleep trends, HRT adherence, and symptom tags - all layered over every lab result.
✓Skin temperature spikes across your full panel — objective hot flash frequency before every visit
✓HRV and sleep fragmentation trends — flag physiological deterioration weeks before the next appointment
✓HRT adherence with timestamped logs — distinguish missed doses from missed patch changes
✓Lab-to-symptom overlay — FSH and estradiol shown alongside skin temp and HRV from the same period
✓Symptom tag counts — hot flashes, night sweats, mood changes, and brain fog timestamped and trended
✓Update HRT schedule, lab interval, and coaching goals from the portal — reflected immediately in Isabella's coaching
*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 perimenopause panel between appointments?
30-minute demo - hot flash detection, HRV dashboard, HRT adherence, RTM billing walkthrough.
Monthly reports & workflow
The full picture arrives
before every appointment.
Isabella compiles a monthly report covering hot flash frequency, HRV and sleep trends, HRT adherence, lab history, and symptom tags - auto-attached to your EHR before each visit. Your 10-minute appointment becomes a clinical decision, not a history-taking session. The report also supports RTM billing documentation.
✓Hot flash frequency — weekly counts from skin temperature spikes and patient tags, charted over 30 days
✓HRV and sleep summary — trend, fragmentation pattern, and night sweat correlation
✓HRT adherence log — dose or patch schedule, percentage on time, missed doses flagged
✓Lab result trend — FSH, estradiol, LH, and progesterone overlaid on symptom scores from the same period
✓Isabella's clinical summary — key observations and suggested discussion points for the visit
✓RTM documentation — routine completion log with day counts supporting 98977 (16+ days) or 98985 (2–15 days)
Monthly report — Sandra K.*
Hot flash tags this month38 occasions ↑
Avg HRV (Apple Watch)34ms ↓
Sleep efficiency61% ↓
HRT adherence78%
Routine days completed24 of 30 ✓
Last FSH / estradiolDue for recheck
Isabella · For provider
"Worsening hot flash burden over 4 weeks correlates with declining HRV and sleep fragmentation. 78% HRT adherence — review whether Saturday patch changes are being missed consistently. Recommend FSH and estradiol recheck before considering dose adjustment. 24 routine days completed — RTM 98977 eligible this month."
RTM billing
Perimenopause qualifies for RTM.
No second condition required.
Unlike CCM, Remote Therapeutic Monitoring (RTM) does not require patients to have two or more chronic conditions. Perimenopause alone qualifies. Ziva's daily routines - HRT logging, symptom tags, and wellness check-ins - generate the data transmissions required for billing. New 2026 codes mean even partial engagement (2–15 days) is now billable.
Full engagement — 16–30 days / month
98975Initial setup & patient education (once)~$20 once
98977Device supply · 16–30 days/month~$40/mo
98980Treatment management · first 20 min~$50/mo
Partial engagement — 2–15 days / month (new 2026)
98985Device supply · 2–15 days/month~$40/mo
98979Treatment management · 10–19 min~$25/mo
Add-on
98981Treatment management · each additional 20 min~$45/mo
Ziva's daily routines and check-ins constitute the data transmissions for RTM device supply codes. Review eligibility and documentation requirements with your billing team. Approximate Medicare rates - commercial rates (the majority of your perimenopause panel) typically higher. 98985 and 98977 are mutually exclusive per billing period.
RTM revenue estimate
Perimenopause patients on Ziva
25
5150
Engagement tier
Device supply (98977)$1,000/mo
Treatment management (98980)$1,063/mo
Add-on management (98981)$563/mo
Monthly RTM revenue estimate
$2,063
$24,750 annually
What drives RTM day count
🌡
Daily wearable sync
Each day skin temperature, HRV, and sleep data syncs from the wearable - counts as a data transmission day
📋
Daily routine completion
HRT log, symptom tag, or wellness check-in - each completed routine day counts toward the billing threshold
💊
HRT adherence log
Every logged dose, patch change, or gel application is a timestamped transmission - supports both adherence tracking and RTM documentation
Illustrative only. Approximate Medicare rates - most perimenopause patients are commercially insured and rates typically differ. Consult your billing team before go-live.
Book a demo
See Ziva in action with
your perimenopause panel.
30 minutes. Hot flash detection demo, HRV dashboard, HRT adherence tracking, RTM billing walkthrough, and a pilot design for your practice.
✓Live walkthrough of skin temperature hot flash detection and HRV dashboard
✓HRT adherence tracking and routine completion for RTM billing
✓Monthly report format and EHR auto-attachment demo
✓First pilot cohort enrolled within 2–3 weeks of go-live
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
No - this is a key distinction from CCM. RTM (Remote Therapeutic Monitoring) does not require patients to have two or more chronic conditions. Perimenopause alone qualifies as a condition being monitored. Ziva's daily routines - HRT adherence logging, symptom tags, and wellness check-ins - generate the data transmissions required for billing codes 98977 (16+ days) or 98985 (2–15 days, new 2026). Consult your billing team and compliance officer for documentation requirements specific to your payer mix.
Apple Watch (Series 8 and later) and Oura Ring measure wrist and peripheral skin temperature continuously during the day and overnight. Hot flashes cause a rapid, measurable rise in skin temperature - typically 0.5–2°C above baseline - that resolves within minutes. Ziva's algorithm identifies these temperature spikes, timestamps them, and logs frequency and duration. The patient can confirm each spike with a quick tag ("hot flash") for clinical validation. This gives your dashboard an objective count of vasomotor events that was previously only available via expensive ambulatory monitoring devices.
Ziva supports oral estrogen tablets, transdermal patches (including twice-weekly and weekly schedules), topical gels and sprays, vaginal rings, and combination regimens including progesterone co-administration. Each form has its own reminder and logging schedule. Patch change days are tracked separately from daily oral dosing. Late applications are flagged. Providers set the HRT type, dose, and schedule from the portal, and Isabella coaches the patient on the correct administration routine.
FSH (follicle-stimulating hormone), estradiol (E2), LH, progesterone, and AMH (anti-Müllerian hormone). Providers or patients enter results when available, and Isabella overlays each result on the symptom burden, HRV history, and hot flash frequency from the same period - making the relationship between hormonal status and how the patient is actually living visible over months. Thyroid panel (TSH, Free T4) is also tracked, as thyroid dysfunction is common in perimenopausal women and its symptoms overlap significantly.
Apple Watch (Series 8+ for skin temperature), Oura Ring (Gen 3+), Garmin, Fitbit, and other devices syncing via Apple Health or Google Fit. Skin temperature data for hot flash detection requires a compatible device - Apple Watch Series 8 or later, or Oura Ring Gen 3 or later. HRV, sleep, resting heart rate, and activity data are available from all supported wearables. Ziva works without a wearable - HRT adherence, symptom tags, and lab correlation are available from the app alone.
Yes. Fully HIPAA compliant, BAA available. All PHI encrypted in transit and at rest. Patient data is never sold or used for advertising. US data residency. Security documentation and DPA available for your compliance team.