Improve Efficiency, Accuracy, and Insights 

As part of the Epic system of applications, Tapestry offers health plans a more integrated, efficient way to manage their operations. Tapestry consolidates multiple modules into one system to give payers a single source for comprehensive information about a covered member. Tegria’s deep experience working with payers across Epic’s application suite uniquely positions us to help with your Tapestry needs. Let’s work together to enhance your operational efficiency and reduce administrative burden.  

Our expertise spans a wide variety of Tapestry modules and services, including:

Utilization Management Optimization 

• Optimize your referral auto approval rate to ensure that administrative review time is focused only on cases that truly require manual intervention.  
• Enhance referral notification workflows to reduce the time your staff spends reviewing and editing messages. 
• Support the implementation, maintenance, or enhancement of referral 278 transactions with upstream payers or other downstream systems.  

Provider Directory and Network Utilization  

• Optimize provider network configuration to support utilization goals.  
• Design, configure, and maintain PCP and specialist provider records, including rosters to support member attribution, claims adjudication, and capitation arrangements.  

Claims, Provider Contracts, and Benefits Optimization  

• Evaluate current system configuration to improve claim auto adjudication rate. 
• Optimize claim review workflows through work queue configuration and training documentation.  
• Support your provider contracting team to configure, audit, and test existing and new provider contracts.  
• Provide your benefits team with additional resources to configure, audit, and test new configurations for the upcoming plan year.  

Business Intelligence and Reporting 

• Enhance operational reporting with tools directly embedded in Tapestry, including:  
  • Dashboards to support executive and managerial insights to drive decision-making.
  • Scorecards to manage productivity.
  • Reporting Workbench reports that empower staff through self-service reporting where appropriate.  
• Supplement your business intelligence team with additional resources to build, maintain, or enhance Tapestry Clarity reporting and meet compliance requirements.  

Strategy and Growth  

• Leverage Tegria’s expertise to develop and implement a strategy to bring a new product type, line of business, health plan, or business model onto your existing Tapestry configuration. 
• Assess, plan, and implement new Tapestry modules or complementary Epic applications, such as Compass Rose. 
• Assess the potential for Payer Platform implementation. 

Wherever you are in your Tapestry journey, we can help you reach your goals. Whether you have a few questions or you’re facing large obstacles, we’re right beside you, ready to solve, resolve, and wow.