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NEW QUESTION # 79
Bloomington Caregivers needs to use the objects for the Clinical data model as part of its new Health Cloud implementation.
Which preference should Bloomington Caregivers' administrator ensure is enabled?
Answer: D
NEW QUESTION # 80
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 # 81
A payer is implementing Health Cloud and wants to leverage predefined rules for its prior authorization request review process. The payer would like to leverage out-of-the-box Health Cloud functionality to drive speed to value.
Which prebuilt feature should a consultant recommend the payer leverage?
Answer: B
Explanation:
Step 1: Requirement Analysis
The payer wants to use predefined rules for prior authorization request reviews, seeking out-of-the-box Health Cloud functionality for speed to value.
Step 2: Health Cloud Prior Authorization & Rules Engine
The Expression Set Templates in Health Cloud provide a prebuilt, configurable framework to automate and standardize prior authorization request reviews. These templates contain reusable logic and criteria that can be easily tailored and applied to common authorization scenarios.
Extract:
"Use Health Cloud's prebuilt Expression Set Templates to accelerate prior authorization configuration. These templates enable payers to implement standardized review criteria and automate decision logic without building rules from scratch." Administer Health Cloud - Utilization Management and Expression Sets Integration Procedures, FlexCards, and OmniScript Templates are OmniStudio tools for integration, UI, and guided processes, but Expression Set Templates are the feature specifically designed for rules automation in Utilization Management.
NEW QUESTION # 82
Bloomington Caregivers is implementing Virtual Care in Health Cloud.
Which three steps are required as part of the setup?
Choose 3 answers
Answer: C,D,E
NEW QUESTION # 83
A consultant is working with an insurance provider to set up prior authorizations in Health Cloud. The provider requires a display of preauthorization outcomes from its external system which manages the end-to-end prior authorization process.
Which solution is appropriate to meet this use case?
Answer: A
Explanation:
In Salesforce Health Cloud, when dealing with prior authorizations, the correct data model objects are:
Service Preauth → Represents the overall prior authorization request (at the header level).
Preauth Detail → Captures the individual service line items or outcomes associated with the prior authorization.
This structure allows Health Cloud to integrate with an external utilization management system that handles the full prior authorization process. The Service Preauth object acts as the container for the request, while Preauth Detail records capture outcomes, decisions, and details returned from the external system.
This is exactly suited to the requirement:
"The provider requires a display of preauthorization outcomes from its external system which manages the end-to-end prior authorization process." Why not the others?
A . Plan Benefit and Plan Benefit Item - These are used to model insurance plan coverage and benefits, not authorization workflows.
B . Care Preauth and Care Preauth Item - These are older, deprecated objects in favor of the Service Preauth data model.
D . Care Request and Care Request Item - These are used to track referrals and service requests (e.g., a doctor requesting lab work), but not prior authorization outcomes.
Salesforce Health Cloud Reference:
Salesforce Health Cloud Developer Guide - Utilization Management Data Model:
"The Service Preauth object represents the prior authorization request and its details. The Preauth Detail object contains service line items and outcomes for the prior authorization request." Salesforce Help: Utilization Management Data Model Salesforce Health Cloud Implementation Guide - Prior Authorizations
NEW QUESTION # 84
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