FAQs

Physician | Practitioner | Healthcare Organization | PC Ownership

Physician FAQ

We provide physicians with secure, compliant and convenient collaboration opportunities that expand their practice and maximize their earning potential.
Clinical collaborations are regulated by complex rules that vary based on state and clinical specialty. Our chief focus is maintaining the compliance of all of our collaborators inclusive of:
• Contractual specifications
• State capacity limitations
• Chart reviews, check-ins, referrals
• Geographic limitation and proximity requirements
• Quality Assurance requirements
• Speciality requirements
Depending on the services you want to support, the below outlines the general requirements for each collaboration:
Monthly Meetings: meeting with your provider at a regular cadence, typically via teleconference in a group or individual setting. These meetings may support general clinical and professional development questions as well as other aspects of the collaborative relationship.
In states such as Georgia, Tennessee, & Alabama there could be additional in person meeting requirements which we will supply compliance information for if you are collaborating in those states.
Ongoing support: review and respond to clinical questions and escalations raised by the provider through the Zivian Health platform
Chart review: Conduct a specified number of monthly chart reviews, which depends on the state you are collaborating in.
Physicians will need to complete an enrollment form, disclosure form, credentialing profile, and W-9.
Yes! You will be required to share the total collaborative agreement you have outside of Zivian Health so we can make sure you do not exceed the allowable capacity. Each state has different requirements, so we’ll request the information by state.
Zivian Health provides medical malpractice insurance to physicians. Once you are in an active collaboration there will be a COI assigned to you. We do require that each collaborating provider also add you as a secondary provider on their malpractice insurance.
Payment is issued on a monthly basis per individual executed and active APP collaboration. Agreements are executed once you and the APP have signed the agreement. You will be paid on the 15th of each month, following the first full month of collaboration. If collaboration commences in the middle of a billing cycle, you will be paid the following pay date.
Please note that if you are collaborating in a state that requires Board approval, the collaboration won’t be active until you receive approval.
The onboarding process typically moves as fast as you do. Most physicians are able to be onboarded in as little as 3 days.
We know how time consuming finding a mutual time is so we ask for this information to be able to help streamline the process for you and the APP. As you are onboarded, we will also use this to connect you with potential collaborators, as approved by you.
When physicians and providers enroll with Zivian Health, we collect information that helps us determine their matching preferences based on the services they need, scope and licensure. We work to find matches that we feel will be long-lasting collaborative relationships.
Certain providers may need the ability to prescribe controlled substances through a collaborative agreement. Prior to accepting any agreement, all physicians are required to meet with their potential collaborators to discuss the feasibility.
During the physician intake process, a physician may also provide specific requirements for these arrangements, such as EHR preferences and other limitations.
Zivian Health’s credentialing process is designed for accuracy and ease. We’ll receive your input via a secure onboarding link and proceed to conduct automated primary source verifications. Our team reviews all results, resolving any discrepancies, and investigates any and all flagged issues via committee to ensure our process is up to NCQA standards.
All of our results are available to you via our platform. If there are additional inputs or licenses to be added, please reach out to support@zivianhealth.com to update accordingly.
Yes, depending on state regulations, you will get matched with a provider that specializes in your same practice area.
Yes, all potential matches are shared with physicians prior to introducing the two parties. You will receive an offer that provides information about the provider and the compensation rate per month for the collaboration.
We recommend returning responses within 24-hours. At the beginning of a collaboration, its a best practice to work with your APPs and create a timeline that works for both parties.
Our general recommendation is to use a calendar system that supports group meetings, however, each physician gets to determine their process for handling their monthly meeting commitments.
We have found success in the two models below:
1. Physicians have a dedicated and predetermined date and time for all monthly meetings with all collaborators.
2. Physicians provide a link to their schedule to all APPs to book and maintain the monthly meeting, however this will require the physician to ensure that the APPs have the meeting scheduled.
Charts are shared via Zivian Health’s platform. Our platform allows APPs to upload and share charts with their collaborating physicians.
Once you have assigned collaborators, you will be able to collaborate through the platform using HIPAA compliant chat and secure messaging. Before you are linked, you will be connected by email to ensure the collaboration is mutually beneficial.
When you receive a new license you are able to send us the new license information. We will add any new license information to your Zivian Health profile.
Yes, we require an introductory meeting with the APP collaborator before we will send the collaborative agreement. This allows you to meet and determine if the collaboration will be a good fit. If at any time during an existing collaboration you would like to terminate, you can do so with 30-days notice. This ensures all parties can have enough time to find alternative arrangements and continue practicing in a compliant and safe manner.
If you have concerns about any of your collaborators, please notify us as soon as possible so that we may attempt to remedy the situation.
Currently, we send compensation to physicians via their Bill.com accounts. You will receive a monthly payout report that will list all of your active collaborations with a breakdown of the compensation you are receiving from each collaboration.
Yes. If the APP requests coverage for additional practices/platforms or prescribing controlled substances, your monthly compensation will increase for that collaboration. We will reach out to you for approval of the changes before updating the collaboration agreement.
Both a Collaborating Physician and a Medical Director play important roles in healthcare. A Collaborating Physician primarily provides supervision and guidance to advanced practice providers, ensuring their clinical practice aligns with regulations and standards. On the other hand, a Medical Director holds a leadership position within a healthcare organization and is responsible for overseeing and optimizing medical services and operations on a broader scale. Each role has a different set of expectations.
To help physicians serving in different roles, we offer a range of resources to facilitate their learning and growth. The support we offer includes:
Helpful Guides: We provide written guides that outline the responsibilities, challenges, and best practices associated with serving as a collaborating physician, medical director or PC owner. These guides serve as handy references that physicians can consult whenever needed and help start a baseline understanding of the different requirements, expectations and opportunities.
Training Videos: Physicians can access our library of videos at their convenience to learn about essential skills, effective communication, regulatory compliance, platform functionality, and more.
Newsletters and Blog Posts: We share newsletters and blog posts that cover industry trends, case studies, success stories, and expert insights. These resources not only keep physicians updated but also offer valuable perspectives on excelling in other roles as well.
Webinars and Workshops: We host webinars and workshops led by experienced professionals who share their practical knowledge and answer questions. These events create opportunities for physicians to interact, learn from peers, and gain hands-on experience.

Practitioner FAQ

Zivian Health offers a range of services that benefit the work of nurse practitioners and physician assistants.
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.
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.
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.
A collaborating physician is an MD or DO who has agreed to “collaborate,” or supervise the clinical work of a nurse practitioner or physician assistant 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 Health tries to go beyond this baseline requirement and build truly empowering and meaningful relationships.
The key components of a collaborating relationship can vary depending on your state’s 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 Health always encourages include:
A Collaborating Agreement: A contract between a nurse practitioner or physician assistant and their 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. Check-ins are a great time to ask both clinical and professional development questions, and they are 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 specific number of monthly chart reviews.
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 some states allow full autonomy for nurse practitioners 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.
Pricing is based a variety of factors including the number of practice locations, if you'll be prescribing controlled medications, specialty preferences, and state of practice.
Learn more here.
No, we do not require an initiation fee beyond the agreed upon fee in the service agreement. If additional services or collaborations are needed beyond what was initially discussed, additional fees may be included. However, prior to billing, all fees are captured in the service agreement.
Yes. All physicians are vetted, verified and credentialed by Zivian Health prior to being enrolled.
This depends on state regulations.
In many states, nurse practitioners and physicians are not required to have matching specialties in order to collaborate. In some states, such as Georgia, NPs are required to have physician collaborators with comparable specialties. Currently, all physician assistants are required to practice under the supervision of a physician.
Our role is to help make sure you are matched with a physician that meets all the regulatory requirements so you don’t have to worry. All of these variables are taken into consideration during the matching process.
At Zivian Health, nurse practitioners and physician assistants can find a collaborating physician in a few simple steps. No need to worry about finding your own legal team or physician — we've got you covered.
1. Complete our intake form which helps us determine your needs.
2. After you apply, our team sends you a free quote for services based on the information you provide. Once you review and confirm your quote, you’ll begin a brief onboarding process.
3. Complete a simple onboarding form and submit basic documentation. Our team will ensure you are credentialed and create your Zivian Health profile.
4. Zivian Health matches you with a physician that aligns with your needs. You meet with your physician to confirm the match.
5. Zivian Health creates your collaboration agreement and sends it to you for your review and signature.
6. Start collaborating!
We also provide ongoing guidance and training on how to have a helpful, supportive and mutually rich collaboration with your physician collaborator.
After you apply and provide all required information and documents, Zivian Health shares your collaboration offer with our nationwide network of doctors.
In most cases, we find matches for NPs and PAs 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 your state’s geographic and meeting requirements.
We provide regular updates for all providers throughout the matching process, and will work with you if we anticipate any issues with finding you an excellent physician collaborator.
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.
Yes. We require that you have an introductory meeting with your collaborating physician match before your collaboration begins.
After a potential collaboration is identified, you will receive an email requesting you to schedule time with your collaborating physician match. This is a great time for you to ask questions about the collaboration, understand their role and determine if the partnership will benefit you and your needs.
After you meet, both you and your physician will have the option to accept the collaboration and sign the proposed collaborative agreement, which will also be shared with you for signature.
Yes, you will add your collaborating physician to your medical malpractice policy.
You and your physician should set expectations of acceptable response times and availability. Typically, physicians will respond within 24 hours depending on your specialty and the nature of the question or issue.
Yes. If you feel that your assigned collaborating physician is not a suitable match, either after the initial meeting or after you have signed a collaboration agreement, we are happy to help you find another collaborator.
If you have any concerns at any point, please let us know so that we can try to remedy the situation.
We recommend all physicians schedule their collaborative meetings with each advanced practice provider via online 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, which are tracked and attested to in the Zivian Health platform.
Collaborating physicians will support nurse practitioners and physician assistants with clinical questions, both about specific patients and medical knowledge.
Even if they do not know the answer to a question, Zivian Health has a very diverse roster of specialists that your collaborator can rely on for additional support.
Your collaborating physician may also provide support on your professional development.
Charts can be shared via Zivian Health’s platform. Our platform allows advanced practice providers to upload and share charts with their collaborating physicians.
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.
Please reach out to support@zivianhealth.com at any time if you are experiencing difficulties reaching out to your physician collaborator.
The Zivian Health platform has a payment portal for quick and easy transactions. Once your profile is created, you can choose your payment method and set up automatic payments if desired.
Zivian Health will email you a monthly invoice for your records.
Yes, if your collaboration starts mid-month, you will be charged a prorated amount in your first invoice.
Fees are due the 5th of every month. Zivian Health invoices for the month in advance.
The Zivian Health platform has a payment portal for quick and easy transactions. If desired, you can set up automatic monthly payments.
Usually, monthly meetings between advanced practice providers and their collaborating physicians are virtual. However, some APPs and physicians prefer to meet in person.
It’s important to vet one another on ideologies and philosophies of care. Disagreements happen, and they are usually healthy debates.
However, if you are experiencing a conflict that is significantly affecting the quality of your collaborative relationship, please reach out to support@zivianhealth.com.
Zivian Health covers malpractice insurance on behalf of physicians, and physicians are secondary to NPs and PAs. The list of physicians named in malpractice suits are little to none due to the fact that the physicians aren’t attending or administering care.

Healthcare Organization FAQ

Zivian Health Software: Automate compliance, manage healthcare collaborations, elevate clinical quality, train your team, monitor licensing and credentialing, and workforce reporting.
Healthcare Collaborations: Connect with a nationwide network of supervising physicians or import and manage your in-house collaborations.
PC Ownership: Connect with experienced physician PC Owners in healthcare and telehealth. Stay confident in your compliance, improve care standards and build in healthcare.
Medical Directorship: We provide physician leaders for Medical Directorship, ensuring the highest standards of patient care and operational efficiency in your practice.
Licensing: Expand your team’s licensure and ensure you are aligned with state requirements. Our team of compliance experts helps you navigate all state rules.
Yes, we support all types of organizations and collaborations.
Zivian Health can support your scaling needs. We work with physicians and providers in all specialties and within all 50 states.
We support advanced practice provider supervision, PC Ownership, and Medical Directorship.
Zivian Health can find a physician match for most partners in 3-5 business days. Turnaround times can be impacted by the state(s) where you require supervision and other specific needs, such as specialty.
Yes. The Zivian Health platform provides visibility into collaboration status, attestation status, and high-level insights into compliance and quality assurance.
Yes, Zivian Health takes privacy and security very seriously. Zivian is HITRUST certified, a security assessment program recognized as the global standard for information security that has been adopted by over 80% of U.S. hospitals and health systems.
Zivian Health works with partners on an annual basis, but services can be cancelled at any time as long as a 30-day notice is provided per agreement terms.
Zivian Health has a standard agreement structure that meets the needs of most partners. This standard structure cannot be changed, but the content of the agreement can be changed to suit your needs.

PC Ownership FAQ

1. Experience: The choice of physician PC Owner can be very impactful to the business in both good and bad ways. Zivian provides a network of several thousand physicians with experience and familiarity with these types of roles, ensuring they are lubricants to the business and not obstructionists.
2. Quality: Zivian vets all physician candidates in advance and on an ongoing basis to ensure clean licensure and records, mitigating the risk of something impacting your ability to operate.
3. Certainty: Should you want to change your PC Owner to a different physician for any reason, Zivian will replace the PC Owner at no expense to you.
4. Speed: Zivian health can identify a physician PC Owner for your business in days and have necessary paperwork set up within a week.
5. Knowledge: Zivian hosts monthly advisory meetings with all PC Owners, allowing them an opportunity to share best practices and stay ahead of an evolving compliance landscape.
The state-by-state rule that requires the practice of medicine should be governed by individuals with clinical expertise rather than commercial or corporate entities.
CPOM protects the integrity of doctor-patient relationships and helps facilitate the practice that medical decisions should be based on clinical judgement versus financial considerations.
CPOM is a patchwork of state-specific regulations, each with its own nuances and exceptions making it very complex to understand nationwide.
The operating business (also known as a Management Services Organization, or MSO) partners with a Professional Corporation (often times referred to as a “friendly PC”) that administers the clinical care. This entity is wholly owned by a physician licensed in that state, who offers important medical oversight, expertise, and operational support to the PC and the MSO.
The physician will own 100% of the friendly PC, but the operations and actions of the PC are done in lockstep with MSO. The MSO has influence through 1) the operating agreement of the PC and 2) a separate advisory agreement signed between the PC Owner and the MSO.
1. Regulatory Compliance: The primary purpose of the PC Owner is to help a healthcare business operate in a manner that complies with CPOM laws. A PC Owner also ensures that the business complies with other healthcare laws, including HIPAA (Health Insurance Portability and Accountability Act), billing and coding regulations, and other relevant guidelines.
2. Medical Oversight: A PC Owner is responsible for overseeing the medical aspects of the business. PC Owners make sure that patient care protocols are followed, review medical decisions, and maintain high standards of patient care.
3. Business Structure: A PC Owner helps structure the business in a way that aligns with legal requirements. This includes determining who can be involved in decision-making processes and what types of services can be provided by the business.
4. Strategic Direction: The PC Owner may contribute to the strategic planning and overall direction of the business. They provide valuable input based on their medical expertise, helping to guide decisions that align with best practices in the healthcare industry.
Yes, all physicians are thoroughly vetted, verified and credentialed by Zivian Health prior to being enrolled in our network.
We can find a physician match within most requested timeframes.
Turnaround times can be impacted by your specific circumstances, such as business/practice type, geographic reach, and scope of work. However, we can usually match you with a physician in 3 to 5 days if needed.
Creating and structuring a new PC with the support of Zivian Health typically takes 3 to 5 months.
No, we do not require an initiation fee beyond the agreed upon fee in your service agreement. If additional services are needed beyond what is initially discussed, additional fees may be included. However, prior to billing, all fees are captured in the service agreement.
We recommend that you provide your own legal representation. However, if you do not currently have legal counsel, we are happy to connect you with our network of legal representatives. If you are having any issues with this part of the process, just let us know.
If needed, we can refer the physician PC Owner to legal counsel. If preferred, the physician can act as their own legal counsel.
Expanding your PC into additional states is easy! Our physician PC Owners are licensed in all 50 states, and we can provide matches that support expansion. Zivian Health also assists with licensing.
Pricing is based on a variety of factors including scope of work, geographic reach, and level of involvement. The PC Owner begins receiving payment when the MSO / business is fully set up and complete. Your PC Owner is paid via your monthly invoice/rate with Zivian Health.
When structuring a PC with a physician PC Owner, the PC-MSO operates with one bank account. The MSO/practitioner maintains power of attorney on the bank account, can retrieve funds from the account at any time, and can utilize those funds for business expenses including PC owner compensation. This payment can be executed compliantly through Zivian Health to avoid fee splitting and additional compensation requests from the PC Owner.
Yes, you can cancel your services at any time. Zivian works with partners on an annual basis, but services can be canceled at any time as long as a 30-day notice is provided per agreement terms.