Zivian Documentation & Compliance Requirements

Outline of how to correctly document all attestations for compliance

Monthly you are required to login to your Zivian profile and submit your attestations. When logging in, you are required to review and confirm all requirements for each state you have a collaboration in. Failure to complete these monthly requirements may result in termination of your agreement and contract as its key to stay in compliance.

How to Access Your Collaborations in the Platform

Once your collaborative practice agreement has been signed, it will be added to the Zivian platform. You will be able to search for any collaborations that you have through Zivian by clicking the “Collaborations” button in the top left corner of the page.

The Collaborations view can be filtered by state, monthly attestation status, or collaboration status. If any of your collaborations have monthly requirements that still need to be completed, they will have an “Action Required” status next to them in the list.

To view details about each collaboration, click your collaborator’s name and you can view additional information about them. Here you will find your collaborator’s contact information, and your collaboration documents.

If you see any “action required” flags, that means that there is still an outstanding monthly requirement that has not been completed.

Once you have completed your monthly attestations, the “action required” flag will change to “completed”. You will also be able to download your attestation report and keep it with your other collaboration records in the “Documents” sections within your profile and under each individual collaboration.

All of your documents related to your collaboration and your relationship with Zivian can be found in the Documents section under the Profile tab on the left.

Chart Reviews

Depending on the state and the nature of the collaboration, different regulatory requirements may mandate a certain amount of chart reviews. These reviews play a pivotal role in ensuring patient safety, compliance with regulations, and the overall quality of healthcare services.

When reviewing health records, there are specific elements that must be assessed, as well as specific areas of focus as requested by enterprise clients. We have outlined below the key components that collaborating physicians may focus on during EHR reviews:

Medical History	Review the medical history, including previous illnesses, surgeries, and chronic conditions. Assess the accuracy of family and social histories, as they may impact treatment decisions.
Chief Complaint and Presenting Symptoms	Evaluate the chief complaint and present symptoms to understand the reason for the current healthcare encounter. Ensure that the documentation captures the patient's concerns and symptoms comprehensively.
Assessment and Diagnosis	Evaluate the assessment and diagnosis based on the available information. Verify that the diagnosis aligns with the patient's symptoms and/or documentation.
Documentation of Medical Necessity	Review the patient's medical history and the documented medical necessity for the prescription of controlled substances. Verify that the patient's condition meets the criteria for such treatment.
Quantity and Dosage	Ensure that the prescribed quantity and dosage of controlled substances are appropriate based on the patient's condition, medical history, and treatment guidelines.
Treatment and Follow-up Plans	Review the treatment plan, including medications, procedures, and referrals. Ensure that treatment options are evidence-based and aligned with best practices.
Progress Notes	Scrutinize progress notes for each encounter to assess the continuity of care and ensure that notes are comprehensive and provide a clear picture of the medical history.
Care Coordination and Referrals	Confirm that referrals to specialists or other healthcare providers are made when necessary. Ensure that care coordination efforts are well-documented.
Prescription Monitoring Programs (PDMPs)	In states with Prescription Drug Monitoring Programs, confirm that the healthcare professional is using these databases to check a patient's prescription history for controlled substances to prevent overuse or misuse.
Compliance with Regulations	Verify compliance with state and federal regulations governing telemedicine, EHR usage, and patient privacy (e.g., HIPAA)