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NEW QUESTION # 74
A payer needs to implement a program to address the rising healthcare expenses and ensure affordable care for its members. The payer aims to strike a balance between quality care and managing the cost of care effectively by streamlining its approval processes for care requests. Which capability in Health Cloud helps the payer accomplish this?
Answer: B
Explanation:
Utilization Management (UM) enables health plans to evaluate medical necessity, appropriateness, and cost- efficiency of healthcare services through prior authorization, concurrent review, and retrospective review.
Utilization Management structures care requests, authorization review, medical-necessity determination, concurrent review, and related payer-provider approval workflows. From a solution-design perspective, the selection fits the requirement because it uses the Health Cloud capability or data model that directly represents the business need, rather than introducing a parallel custom structure or a feature intended for a different stage of the patient, member, provider, or payer lifecycle. The remaining options do not directly satisfy the stated requirement; they either address a different functional domain, provide only part of the required behavior, or introduce unnecessary customization compared with the selected Health Cloud approach. This approach also keeps the solution aligned with the standard Agentforce Health data and process model, which is important for maintainability, reporting, interoperability, and consistent user access. In practical terms, the consultant should configure and validate the selected elements (Utilization Management) against the scenario ' s acceptance criteria and confirm that the intended users can access the underlying records and functionality.
Study Guide references/topics:Design - Utilization Management
NEW QUESTION # 75
Bloomington Caregivers has decided to enable Integrated Care Management so that its end users can leverage Health Cloud Assessments. Administrators must now configure their org to be able to use Assessments.
Which three steps should the administrator take as part of the org setup to enable Assessments?
Choose 3 answers
Answer: B,C,E
NEW QUESTION # 76
An administrator for Bloomington Caregivers has added an Enhanced Timeline to an existing Patient Lightning page showing patient interactions, including records from a custom object developed to track caregiver preferences. What else should the administrator complete post deployment of the enhanced timeline?
Answer: D
Explanation:
Once configured, the administrator must ensure the Timeline configuration is active and properly placed and saved on the target Lightning record page. Enhanced Timeline displays configured records chronologically while enforcing the user ' s underlying object, field, and record access. From a deployment perspective, the configuration must be activated, licensed, permissioned, or migrated in the correct sequence so that the functionality is available to users without weakening the organization ' s existing security and governance controls. The remaining options do not directly satisfy the stated requirement; they either address a different functional domain, provide only part of the required behavior, or introduce unnecessary customization compared with the selected Health Cloud approach. This approach also keeps the solution aligned with the standard Agentforce Health data and process model, which is important for maintainability, reporting, interoperability, and consistent user access. In practical terms, the consultant should configure and validate the selected elements (Add the Timeline component to the Patient Lightning page and activate the Timeline.) against the scenario ' s acceptance criteria and confirm that the intended users can access the underlying records and functionality.
Study Guide references/topics:Deploy - Enhanced Timeline
NEW QUESTION # 77
How should a consultant recommend modeling a physician ' s locations of service, when the physician practices at multiple hospitals and clinics?
Answer: C
Explanation:
Healthcare Practitioner Facility is the standard junction object in Health Cloud representing a practitioner ' s practice affiliations across multiple healthcare facilities and clinics. From a solution-design perspective, the selection fits the requirement because it uses the Health Cloud capability or data model that directly represents the business need, rather than introducing a parallel custom structure or a feature intended for a different stage of the patient, member, provider, or payer lifecycle. The remaining options do not directly satisfy the stated requirement; they either address a different functional domain, provide only part of the required behavior, or introduce unnecessary customization compared with the selected Health Cloud approach. This approach also keeps the solution aligned with the standard Agentforce Health data and process model, which is important for maintainability, reporting, interoperability, and consistent user access. In practical terms, the consultant should configure and validate the selected elements (Healthcare Practitioner Facility) against the scenario ' s acceptance criteria and confirm that the intended users can access the underlying records and functionality.
Study Guide references/topics:Design - Agentforce Health architecture and implementation
NEW QUESTION # 78
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 # 79
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