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| Section | Objectives |
|---|---|
| Care Coordination and Plans | - Care plan structure and lifecycle - Care program management - Tasks, milestones, and goals |
| Security, Compliance, and Industry Considerations | - Auditability and privacy safeguards - HIPAA and healthcare compliance basics - Data access control in Health Cloud |
| Patient and Member Management | - Consent and privacy considerations - Care team assignment and collaboration - Patient data model and records |
| Health Cloud Fundamentals | - Industry-specific terminology (patients, care teams, providers) - Core concepts of Salesforce Health Cloud - Healthcare data model overview |
| Data Integration and Health Data | - Health data ingestion concepts - Integration with external healthcare systems - FHIR alignment concepts |
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NEW QUESTION # 20
Bloomington Caregivers is looking to streamline the user experience for its call center agents. On the patient's record, the company wants the ability to:
Inform agents about changes in information
View basic details about a patient's insurance
Have a complete view of all engagement interactions in one place
Which three components from Contact Center for Health Cloud should a consultant use to achieve this?
Answer: B,C,D
Explanation:
Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with Reference Record Alerts:
Notify agents of important or recent changes in patient information.
Extract:
"Use Record Alerts to keep agents informed of changes and critical updates on the patient's record."
- Contact Center for Health Cloud Overview
Timeline:
Provides a single, unified view of all engagement interactions, encounters, and activities with a patient.
Extract:
"Timeline shows a consolidated history of patient interactions and engagement, giving agents a complete view in one place."
- Health Cloud: Enhanced Timeline
Member Plan FlexCard:
Displays key patient insurance information directly on the record page.
Extract:
"The Member Plan FlexCard displays essential details about the patient's insurance coverage for agents."
- OmniStudio: FlexCards
Other Options:
A . Identity Verification: Used for verifying caller identity, not information display.
D . Action Launcher: Launches actions/processes, not for displaying info or alerts.
Reference:
Contact Center for Health Cloud Overview
Health Cloud: Enhanced Timeline
OmniStudio: FlexCards
NEW QUESTION # 21
A provider's office wants to verify a patient's insurance plan information and coverage when they call into the call center to book an appointment.
Which capability should a consultant leverage to address this requirement?
Answer: B
Explanation:
Step 1: Requirement Analysis
The provider's office needs to verify a patient's insurance plan information and coverage when a patient calls to book an appointment.
This means checking whether the patient's insurance is active, what services are covered, and any applicable copays or eligibility details.
Step 2: Health Cloud Out-of-the-Box Capability
Benefits Eligibility and Verification is the dedicated Health Cloud capability that allows provider offices and payers to verify a patient's insurance coverage, eligibility, and benefit details in real time, either through integration with payers or using Health Cloud workflows.
Extract:
"Health Cloud offers Benefits Eligibility and Verification, enabling providers and payers to confirm a patient's plan information and coverage eligibility, reducing the risk of denied claims and improving the patient experience." Administer Health Cloud - Benefits Eligibility and Verification Step 3: Review of Options A . Benefits Eligibility and Verification: Directly addresses insurance plan and coverage verification.
B . Intelligent Appointment Management: For scheduling, not insurance verification.
C . Utilization Management: For prior authorizations and care request reviews.
D . Identity Verification: For confirming patient identity, not insurance coverage.
NEW QUESTION # 22
While setting up Advanced Therapy Management, a consultant wants to have patients associated to Care Programs during enrollment. They need to customize the Health Cloud enrollment process to match their customer's process.
What should the consultant clone to customize for the customer, while leveraging out- of-the-box Health Cloud functionality?
Answer: C
Explanation:
In Salesforce Health Cloud Advanced Therapy Management (ATM), the enrollment process for associating patients to Care Programs is driven by OmniStudio OmniScripts.
Salesforce provides out-of-the-box OmniScripts for patient enrollment.
Best practice: Instead of building from scratch, you clone the delivered OmniScript and then customize it to align with your customer's unique enrollment process.
This approach ensures you continue to leverage Health Cloud's standard functionality while tailoring the process flow.
Why not the others?
A . FlexCard - Displays patient/care program info but doesn't handle the guided enrollment process.
B . Flow - Standard Salesforce Flows are not used for ATM enrollment; Health Cloud leverages OmniScripts for these guided workflows.
C . Apex Class - Only needed for custom logic; cloning Apex is not recommended for configuration/customization here.
Salesforce Health Cloud Reference:
Salesforce Health Cloud Implementation Guide - Advanced Therapy Management:
"Enrollment processes for patients into Care Programs are delivered as OmniScripts. To customize these processes, clone the standard OmniScript and modify it to meet your business needs."
NEW QUESTION # 23
A payer needs to work with plan members and medical providers to influence decisions through a case-by-case review of the appropriateness of care.
When gathering requirements for this use case, which two Utilization Management processes should a consultant discuss with the client?
Choose 2 answers
Answer: C,D
Explanation:
Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with Reference Request Review Types:
Utilization Management processes center around reviewing requests for appropriateness of care, with the three main types being Prior Authorization Review, Concurrent Review, and Retrospective Review.
Extract:
"Utilization Management supports prior authorization, concurrent, and retrospective reviews to evaluate care appropriateness case by case."
- Utilization Management in Health Cloud
Care Requests:
Care Requests are the mechanism for providers to seek authorization from payers for drugs, services, or admissions.
Extract:
"Design care request processes to support providers seeking health plan authorization for services, medications, or admissions."
- Health Cloud Utilization Management Data Model
Why not the other options?
A: Next Best Action is more for care management recommendations, not utilization review.
C: Intake agent count is an operational consideration, not a UM process.
Reference:
Utilization Management Overview
Utilization Management Data Model
NEW QUESTION # 24
Bloomington Caregivers is implementing Home Health scheduling with Health Cloud. It must ensure that those who need to schedule the visits have the right permission set license.
Which permission set license should a consultant assign in this scenario?
Answer: A
NEW QUESTION # 25
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