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Ziva Health›Solutions›Primary care
For primary care practices

Fewer ED visits.
More engaged patients.
Between every visit.

A 15-minute visit every six months is not enough to manage a chronic panel. Ziva keeps a continuous line to every patient - device readings, medication adherence and coaching between visits - and hands your team a single reviewed summary before each appointment.

HIPAA compliant · EHR integration · No new hires needed · RPM & CCM eligible · Live in weeks

Book a demo How Ziva helps →
Panel view · this morning
Margaret L., 71*
BP trending up 9 days · HTN + T2D
Escalate
David R., 58*
3 missed metformin doses this week
Watch
Anita S., 64*
Glucose readings steady, weight −6 lb
Stable
Isabella
"Margaret's morning readings have been above target for nine consecutive days and she reports new ankle swelling. I've flagged her for your review and moved her to the top of today's list."
*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.
The gap

The visit is a snapshot.
The disease is a timeline.

Independent practices carry the heaviest chronic burden with the least infrastructure. Between visits, the panel goes dark - and the patients who deteriorate are rarely the ones who call.

Blind between visits
You see a patient two to four times a year. Everything that matters - adherence, symptom drift, blood pressure, weight, mood - happens in the 360 days you can't see.
Care gaps close late
Quality measures and recalls surface a gap months after it opened. By then the patient has already been to urgent care or the ED.
No bandwidth for programs
RPM and CCM are real revenue, but most practices can't hire a care manager and can't spare nurse hours to hit the time thresholds.
The continuous care experience

One continuous line to every patient
on your panel.

The continuous care experience is what happens when monitoring stops being an occasional data pull and becomes a relationship. Isabella, Ziva's AI care companion, reads what the home is already telling us - automatically, every day - and escalates to you only when it matters.

01
Readings, automatically
Connected BP cuffs, scales, glucometers and wearables stream in every day - no app, no form, no effort from the patient.
02
Isabella interprets
Trends, correlations and deviations from the patient's own baseline - not a population threshold.
03
Coaching in the moment
Education, nudges and behaviour support delivered the day something drifts, not at the next visit.
04
Escalation to you
A ranked, documented alert with the underlying data - and a monthly report attached to the pre-visit note.

The patient experiences ongoing care rather than episodic appointments. Your team experiences a filtered queue instead of a data firehose. Engagement stays high across the year, which is exactly what both quality performance and time-based billing require.

How Ziva helps

What Ziva does for
an independent practice.

Ziva is not another dashboard for your staff to check. It is a monitoring layer that does the watching, the coaching and the documentation, and surfaces only what needs a clinician.

Monitoring
Continuous care coverage
Every enrolled patient monitored daily. Deterioration surfaces in days, not at the next scheduled visit.
Triage
Triaged alerts, not raw data
Isabella filters normal variation. Your team sees a short ranked list each morning with the reasoning and data behind each flag.
Documentation
Pre-visit summaries
A one-page interval history lands in the chart before the appointment - adherence, trends, symptoms, what changed.
Adherence
Medication adherence
Timestamped dose logging distinguishes missed doses from mistimed ones, so you adjust therapy on real information.
Quality
Care gap and recall support
Overdue labs, screenings and follow-ups surfaced to the patient conversationally and to your team as a worklist.
Prevention
Proactive, preventative outreach
Risk factors and early drift are flagged before they become symptoms - screening reminders, lifestyle coaching and check-ups scheduled ahead of decline, not after it.
Revenue
Billing-ready time logs
Every monitoring minute and interaction is logged and exportable, so RPM and CCM claims are supported without manual tracking.
Impact

What practices see
in the first year.

Continuous contact changes three things at once: patients deteriorate less, staff spend less time chasing, and previously unbilled care management becomes documented revenue.

Earlier
Deterioration detection
Trends like rising BP or missed doses surface days before an ED visit
Daily
Patient engagement
Isabella reads the home's data every day, not just at the next scheduled visit
Less
Staff chasing time
Isabella handles routine reminders and re-engagement outreach
Illustrative
Program revenue
Modeled RPM & CCM revenue for your panel - see the calculator below

Directional framing based on Ziva's platform capabilities; actual results depend on panel size, payer mix and enrollment.

The full care journey

From device delivery
to billing - Ziva owns every step.

No new staff, no parallel system to learn. Your team sees the alert queue and the chart - Ziva runs everything in between.

01
Device delivery
Order, ship, track
02
Onboarding
Setup, consent, activation
03
Continuous care
Daily readings & coaching
04
Alert triage
Ranked each morning
05
Pre-visit summary
Attached to the chart
06
Documentation
Time logs, audit-ready
07
Patient engagement
Reminders & education
08
EHR sync
Notes & vitals write-back
09
Billing
RPM/CCM auto-captured
Works with your EHR
Epic, athenahealth, eClinicalWorks, NextGen and others via HL7 FHIR R4.
No care manager to hire
Isabella covers the monitoring and coaching hours. Clinical review stays with your team.
Patient-friendly
Coaching and reminders in plain language, multiple languages - no app fluency required.
Transparent economics
Per-patient pricing with revenue modelled up front. See Plans.
Proof

Continuous contact that
changed the outcome.

Conditions covered

The conditions your panel actually carries.

Ziva runs condition-specific protocols. Most primary care patients are enrolled for two or more at once.

HypertensionDiabetesHeart failureCOPDChronic kidney diseaseMental healthThyroidWeightAsthmaAll conditions →
Reimbursement

Care you're already giving,
finally documented and paid.

Most independent practices deliver between-visit care management every week and bill none of it. Ziva captures the time, the data and the documentation the codes require.

RPM — 99453 / 99454 / 99457 / 99458
Device-based physiologic monitoring, 16+ transmission days per month
99453One-time setup & patient education — ~$19
99454Device supply + daily transmission — ~$46/mo
99457First 20 min interactive care management — ~$48
99458Each additional 20 min — ~$39
CCM — 99490 / 99439
Patients with two or more chronic conditions expected to last 12+ months
99490First 20 min clinical staff time / month — ~$62
99439Each additional 20 min — ~$47 (up to 2×)
Complex CCM — 99487 / 99489
60+ minutes/month and moderate-to-high complexity medical decision making
99487First 60 min / month — ~$130
99489Each additional 30 min — ~$67
Ziva's time logs, monitoring records and monthly reports supply the documentation these codes require. Confirm eligibility and rates with your billing team and MAC.
Program revenue estimate
Enrolled patients 100
10typical enrollment ramp400
Program type
Device supply (99454)—
First 20 min (99457)—
Additional 20 min (99458)—
Estimated monthly program revenue
—
— annually
Illustrative national-average estimates. Actual reimbursement varies by MAC, locality, payer mix and documented time.
Self-pay option
Not billing insurance? Charge patients directly.
Set your own price for a monthly monitoring program, membership or package. Connect your payment system to Ziva and get paid directly, alongside or instead of CPT billing.
Connects with
StripeSquarePayPalYour existing system
See plans →
Get Started

See it against
your own panel.

Send us a de-identified panel summary and we'll model enrolment, workload and program revenue for your practice specifically.

✓Eligibility analysis across your chronic panel
✓Workload estimate for your existing staff
✓Program revenue projection by payer mix
✓Implementation timeline — most practices live in 4–6 weeks
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.
Security & compliance

Built for healthcare.
Trusted by clinical teams.

Ziva was designed from the ground up for clinical environments - not adapted from a consumer app. Every data flow, access control, and integration meets the standards your compliance team requires.

🔒
HIPAA compliant
BAA available. All PHI encrypted in transit and at rest.
✅
End-to-end encrypted
All PHI encrypted in transit and at rest. HL7 FHIR R4 compliant data exchange.
🏥
US data residency
All patient data stored and processed within the United States.
📋
Audit-ready logs
Consent records, access logs, and billing documentation stored and exportable.
Questions

Primary care FAQ