Managed Care Functionality

Tapestry automates key workflows and tasks associated with managed care administration by helping provider organizations manage risk and maintain strong, collaborative relationships with payors.

Fundamental operations include the following:

• Membership and Eligibility
• PCP Panel Assignment
• Referral Authorization and Management
• Benefits and Benefit Packages
• Provider Credentialing
• Customer Relationship Management
• Accounts Payable Claims Processing and Payment
• Vendor Contract Management
• Case Management
• Capitation Receipt and Reconciliation
• Capitation Payment
• Premium Billing

For providers, the system helps manage authorizations; compares capitation receipts against eligibility history, and reconciles claim payments against contracts.

A comprehensive benefits engine makes it easy to handle co-pays, co-insurance deductibles, MOOP, tiered benefits, riders, etc., allowing users to make informed decisions and minimize errors. Tapestry integrates provider and payor functionality to provide a flexible solution for your health care management setting today-and tomorrow. Because Tapestry uses the same master files as Epic's other software, it is inherently integrated with the entire suite of Epic's clinical systems.