FAQ – Practitioners

Compliance Is Our Cornerstone: Regulations can vary drastically from state-to-state and are constantly changing. Zivian’s chief focus is keeping you compliant. We create you a custom collaboration agreement that meets all state requirements, find you a reliable collaborating physician, and provide a platform that simplifies compliance with automated notifications, HIPAA-compliant chat and chart sharing, and an exportable audit trail of all activity.

Legal Expertise: The Zivian team handles the drafting of your collaborative agreements. These documents encapsulate the requisite state compliance details and the appropriate protocols, so that you can focus on preparing for practice.

Experienced Advisors: Our experienced physicians are available to offer support, mentorship, and guidance with any clinical questions that you may have. Your collaborating physician will also be able to help you answer questions about specific patients or scenarios when necessary via the review of charts or ad hoc communication.

Software: A dedicated platform for compliant collaborations. The platform not only supports ongoing collaborations with secure messaging and chart reviews, but makes managing your collaboration simple with document storage, automated compliance notifications, and a database of state regulations.

What is a collaborating physician?

A collaborating physician is an MD or DO who has agreed to “collaborate,” or supervise your clinical work in a given State or States where you are both licensed. Collaborating means fulfilling the legal requirements of a physician collaborating with an NP or PA, but Zivian tries to go beyond and truly build empowering and meaningful relationships.

What are the key components of a collaborating agreement?

The key components of a collaborating relationship can vary depending on your State regulations, your organization’s expectations, your clinical specialty, your scope of practice, and the professional relationship you develop. However, some features of a collaborative relationship that Zivian always encourages include:

A collaborating agreement: a contract between you and your collaborating physician that includes both of your responsibilities, and an outline of your clinical protocol;
Check-ins: meeting with your provider at a regular cadence, typically via teleconference. These can be a great time to ask both clinical questions and professional development questions, and is a chance for the clinician and the physician to develop a long-term relationship;
Advice: your collaborator will be available to answer your medical and patient care questions;
Chart review: Your physician will be required to conduct a specified number of monthly chart reviews.

When does a provider need a collaborating physician?

Short answer–it depends! Certain States require that a physician (MD or DO) serve permanently in this role for NPs and PAs to help ensure you are meeting the standard of care, and support you when needed. Other States require a collaborating physician for a specific duration or in certain prescribing contexts, and certain States allow full autonomy for NPs specifically.

Although a collaborating physician is not strictly required for all NPs and PAs, Zivian Health believes a productive collaboration can bring tremendous value to many clinicians and organizations.

What determines pricing for a collaborating physician?

Collaboration pricing is based on state regulatory factors that impact your potential physician matches. These factors include:

Whether the physician must be in the same state or practice location
Ongoing compliance requirements such as chart reviews and quality assurance meetings
Limits on the number of NPs or PAs a physician can collaborate with
Whether or not your collaborator must be a specialist physician

Are there any initiation fees to be matched with a physician?

No, there are no additional, up-front, or hidden fees beyond the price listed in your quote for services. Unlike other companies, we will never require onboarding, matching, or rematching fees from you. Your pricing may change if you request additional services or collaborations, but prior to billing, all fees are captured in your service agreement.

Do physicians go through any credentialing or verification process?

Yes, all Physicians are verified and credentialed by Zivian prior to being enrolled.

Do I have to be matched with a physician in my speciality?

This depends on the state. In many states, NPs and physicians do not have to have matching specialties in order to collaborate. In Georgia, NPs are required to have physician collaborators with comparable specialties. Our role is to help make sure you are matched with a physician that meets all the regulatory questions, so you don’t have to worry. All of these variables are taken into consideration during the matching process.

How do I start the process of finding a physician?

At Zivian, we're committed to simplifying your journey. No need to worry about finding your own legal team or physician – we've got you covered. Our goal is to make the process as seamless as possible for you.

Complete our intake form which helps us determine your needs
Agree to your monthly cost to collaborate with a physician that meets your needs
Create Zivian profile to start credentialing process and submit required documentation
Meet and Greet with Match
Sign Collaborative Agreement
Start Collaborating!

We also provide guidance and training on how to have a helpful, supportive and mutually rich collaboration with your physician collaborator.

How quickly can you match me to a physician?

After all required documents are signed, you will be placed into our matching queue. In most cases, we find matches in 7-10 days. However, if you practice in a state with more stringent regulations, it might take additional time to find a suitable collaborator who aligns with diverse geographic and meeting prerequisites.

We provide updates for all providers in the matching queue and will work with you if we anticipate any issues with finding you a good physician collaborator.

Do you have physicians who supervise controlled substances?

Yes! If you plan on prescribing controlled substances, we will match you with a physician that is open to supervising your controlled substance prescriptions. In Texas, physicians would prescribe Schedule II controlled substances on your behalf.

Will I get to speak to my physician before we begin working together?

Yes. We suggest that you have an introductory meeting with your assigned collaborating physician. After a potential collaboration is identified, you will receive an email requesting you to schedule time with your assigned physician collaborator. This is a good time for you to ask questions about the collaboration, understand their role, and see if a collaboration will benefit you and your needs.

After you meet, the Physician will have the option to accept the collaboration and sign the proposed collaborative agreement, which will also be shared with you for signature.

Do I add my collaborating physician to my existing medical malpractice policy?

Yes, you will add your collaborating physician to your medical malpractice policy.

How long does my physician have to provide a response to a question?

You and your physician should set expectations of acceptable response times and availability. Typically physicians will respond in 24 hours or shorter depending on the specialty and nature of the question or issue.

Is there a process for me to request an alternative collaborative Physician if it is not a good match?

Yes. If you feel that your assigned collaborating physician is not a suitable match, we would be happy to help you find another collaborator. If you have any concerns at any point, please let us know so that we may try to remedy the situation.

Who schedules monthly meetings?

We recommend all physicians schedule the monthly collaborative meetings with each provider by having them book through the physician's calendar link. Our general recommendation is to use a calendar system that supports group meetings. It is the responsibility of the physician to ensure these meetings occur, as tracked and attested to in the Zivian platform.

When should I go to my collaborator for help?

Your collaborating physician will help you with your clinical questions, both about specific patients and about your medical knowledge. Even if they do not know the answer to a question, Zivian Health has a very diverse roster of specialists whom your collaborator can rely on for additional support. Many collaborators will also be helpful in sharing advice on your professional development!

How are charts shared?

Charts can be shared directly within the Zivian Health platform using our chart-sharing tool. Sharing charts is easy — simply access the Chart Reviews tab, select Upload, upload your chart, and your physician will be notified for review. View a quick tutorial on sharing charts here.

If I receive additional state licensures and need additional collaborations, how can I request those adjustments?

You may reach out to support@zivianhealth.com at any time to request updates to your agreement or to request additional collaborations. Please send us a message about the state needed and the number of practice locations that you will need coverage for.

My physician collaborator is unresponsive, what should I do?

Please reach out to support@zivianhealth.com at any time if you are experiencing difficulties reaching out to your physician collaborator.

How do I pay my monthly fees?

Zivian Health has a payment portal within the platform for easy transactions.

Are fees prorated if I start mid-month?

Yes, if your collaboration starts mid-month, you will be charged a prorated amount in your first invoice.

Are the monthly meetings virtual or in person?

Usually, the monthly meetings are virtual. However, some providers and physicians prefer in person. Some states do require in-person meetings, such as Tennessee and Alabama.

What if we don’t align with a provider’s mission/plan?

It’s important to vet one another on ideologies/philosophies. These things happen, and they’re usually healthy debates. However, if you don’t agree with their methods, there are further steps we can take.

What level of liability do physicians have?

Zivian covers malpractice insurance on behalf of physicians, and physicians are secondary to NPs and PAs. The list of physicians named in malpractice suits is little to none due to the fact that the physicians aren’t attending or administering care.