From member enrollment and benefits management to claims processing and provider network coordination, Epic Tapestry provides healthcare organizations with the tools to ensure efficient operations and deliver a seamless patient experience. By automating processes and integrating data across systems, the Epic Tapestry platform helps reduce administrative burden, improve care coordination, and support value-based care initiatives.
This article explores the key features, benefits, and impact of Epic Tapestry in transforming managed care workflows and optimizing healthcare outcomes.
Overview of Epic Tapestry
Epic Tapestry is a comprehensive solution for managing health plan operations and improving operational efficiency and accuracy. It consolidates multiple modules into a unified, providing a single source for comprehensive information about covered members.
As part of the comprehensive system of Epic applications, the Tapestry solution is designed to provide a comprehensive solution for health plans, making it easier for healthcare organizations to manage operations and improve overall patient care. Here’s a closer look at a few key features of Epic Tapestry:
- Streamline member enrollment and track member eligibility in real-time
- Coordinate provider networks and track performance metrics across organizational units
- Simplify claims adjudication and processing to reduce errors and turnaround times
- Seamlessly connect with the Epic ecosystem for improved care coordination and data sharing
- Handle complex benefits structures and plan administration tasks across teams
Understanding Epic Tapestry Functionality
The Epic Tapestry suite consolidates various modules in a single platform, offering specific modules and support resources for complex claims workflows, member and risk management, process referrals, patient billing, claims management, and payments across the health lifecycle.
To meet the specific organizational needs of each care facility or health system, Tapestry empowers users to implement the whole suite of applications or choose the ones that best align with their needs, empowering them to control their own experience and maximize their technical investment.
Let’s take a look at a few key product areas included in the Tapestry suite:
Care Management Capabilities
Utilization management
Leverage advanced analytics functionality and optimized workflows to manage and track clinical and social determinants of health and improve resource utilization.
Customer relationship management
Identify high-risk members, address member inquiries, and manage member relationships and interactions across organizational units.
Member enrollment and eligibility
Review and process member referrals, manage member enrollment and eligibility information, and proactively address any issues with eligibility requirements or member information.
Plan benefits
Manage critical benefits information and plan elements to ensure proper enrollment and alignment between individual benefits plans and organizational objectives.
Claims
Optimize claims management and adjudication processes to handle claims, accounts payable, and other patient billing tasks.
Improved Efficiency and Accuracy
Healthcare organizations can leverage Epic Tapestry to enhance overall care management, improving operational efficiency and accuracy and reducing administrative burdens across the complete Epic suite of Epic applications.
The Tapestry application also empowers organizations to improve risk management and meet critical requirements for Medicare Advantage and Marketplace plans, streamlining Epic system performance and maintaining accurate healthcare data across organizational units.
Financial Management with Epic Tapestry
The Epic Tapestry solution simplifies financial management across healthcare organizations by consolidating core accounts payable, billing, reporting, and other transactional tasks in a single, unified platform. Here are a few key examples of Tapestry’s role in financial management:
- Accounts payable: Streamline, consolidate, and manage accounts payable and financial transactions across organizational units.
- Member premium billing: Manage member premium billing and payment processes to ensure alignment with treatment plans and insurance requirements.
- Financial reporting: Create, run, and analyze financial reports and analytics based on key accounts payable, billing, and financial transaction information.
Best Practices for Epic Tapestry
- Utilize pre-built modules and system integrations to optimize core workflows and processes and maximize ROI across organizational units.
- Access Epic’s built-in support resources and training programs to ensure proper user adoption and task management within each module.
- Customize key product areas to meet specific organizational needs and align with evolving industry trends and requirements over time.
- Monitor and analyze performance metrics and key performance indicators (KPIs) for critical workflows.
Integration with Other Epic Modules
By integrating core Epic modules within the Tapestry landscape and the broader Epic software ecosystem, including key modules like Epic Claims and Epic Managed Care, organizations can facilitate seamless data exchange and interoperability between modules.
Users can also leverage the comprehensive suite of applications to determine key focus areas across the organization and create a comprehensive solution for health plans within each department. This way, organizations can maintain compliance with HIPAA and ICD-10 requirements and ensure patients receive optimal care and have the resources to manage their own care plans, billing information, and outstanding payments.
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Our senior-level Epic consultants have the skills and experience to handle your critical project needs and ensure your internal teams are prepared for continuous improvement and innovation over time.
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