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Salesforce Health-Cloud-Accredited-Professional Exam is designed to test the knowledge and skills of professionals who work with the Salesforce Health Cloud platform. Salesforce Health Cloud Accredited Professional certification is ideal for those who want to demonstrate their expertise in implementing, configuring, and managing the Health Cloud platform for healthcare organizations. Health-Cloud-Accredited-Professional Exam is designed to validate the ability of the professionals to use Health Cloud to its full potential, enabling them to provide better patient care and outcomes.
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Salesforce Health Cloud is a powerful platform that is designed to help healthcare providers manage their patient data and improve patient outcomes. The Health Cloud platform is built on the Salesforce platform and includes a range of features and tools that are specifically tailored to the needs of healthcare providers. The Salesforce Health Cloud Accredited Professional Certification Exam is designed to test the knowledge and skills of professionals who work with the Health Cloud platform.
Salesforce Health-Cloud-Accredited-Professional Certification Exam is an essential certification for healthcare professionals looking to improve their skills and advance their careers. Salesforce Health Cloud Accredited Professional certification validates a candidate's expertise in implementing and managing Salesforce Health Cloud solutions, enabling them to provide better patient care and build stronger relationships with their patients.
NEW QUESTION # 47
A pharma company is implementing Health Cloud and trying to track insurance details related to its patients.
The company wants to track:
A list of all payer organizations
The plans offered by a given payer
The standard benefits available under a plan
Which plan a given patient is enrolled in and their specific insurance details Which set of objects should a consultant implement to meet these requirements?
Answer: A
NEW QUESTION # 48
A call center agent at Bloomington Caregivers wants the ability to look up providers by location and specialty, to schedule an appointment on behalf of their patients.
Which two capabilities should a consultant recommend to enable this requirement?
Choose 2 answers
Answer: A,B
Explanation:
Call center agents at Bloomington Caregivers require tools to streamline provider lookup and appointment scheduling for patients. Salesforce Health Cloud offers specific capabilities tailored to address these needs.
1. Provider Search (Answer A):
Purpose:
Provider Search enables users to locate healthcare providers based on specific criteria such as location, specialty, and availability. This functionality is essential for call center agents who need to identify and select suitable providers for patients.
Features:
Search by provider name, specialty, location, or other attributes.
Filter and sort results to narrow down the provider list.
Integration with the Salesforce Health Cloud data model to access real-time provider information.
Implementation Steps:
Configure Provider Records: Ensure all providers are set up correctly within Salesforce, including their specialties, locations, and other attributes.
Enable Provider Search: Add the Provider Search component to the appropriate Lightning pages or record layouts.
Reference:
Provider Management Overview
Configuring Provider Search
2. Intelligent Appointment Management (Answer B):
Purpose:
Intelligent Appointment Management streamlines the scheduling process by integrating provider availability, patient preferences, and other factors. It helps agents book appointments efficiently while minimizing scheduling conflicts.
Features:
Allows booking appointments based on provider availability.
Enables real-time synchronization with provider schedules.
Offers advanced scheduling logic to ensure compatibility with patient needs.
Implementation Steps:
Enable Salesforce Scheduler: Set up Salesforce Scheduler to integrate appointment booking with Health Cloud.
Configure Appointment Rules: Define scheduling policies, including time slots, duration, and patient-provider matching criteria.
Salesforce Scheduler for Health Cloud
Why Other Options Are Less Relevant:
C . Integrated Care Management:
Integrated Care Management focuses on managing care plans, assessments, and interventions. It is not designed for provider lookup or appointment scheduling.
D . Experience Cloud for Health Cloud:
Experience Cloud is used to create external portals for patient and provider access. While it can complement scheduling systems, it is not directly related to call center agent workflows.
Conclusion:
By implementing Provider Search and Intelligent Appointment Management, Bloomington Caregivers can empower their call center agents to efficiently locate providers and schedule appointments, improving patient satisfaction and operational efficiency.
Reference for Further Reading:
Salesforce Health Cloud Provider Management
Salesforce Scheduler Setup
NEW QUESTION # 49
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: A,B
Explanation:
Utilization Management is a critical component in healthcare that focuses on ensuring the appropriateness, necessity, and efficiency of healthcare services. For payers working with plan members and medical providers, the case-by-case review of care appropriateness requires thorough processes to streamline authorization and review tasks.
* Designing Care Requests to Seek Authorization (Answer B):
* Purpose: The Care Request object in Health Cloud is essential for seeking authorizations from a health plan for specific healthcare services, drugs, or admissions. This object ensures that requests are appropriately documented and tracked.
* Functionality:
* It allows users to create and manage care requests linked to plan members.
* Integrates with payer systems to capture critical details for authorization, such as service codes, plan information, and medical necessity documentation.
* Supports automation through workflows and approvals, speeding up the decision-making process.
* Relevance: By designing efficient Care Requests, the consultant ensures that all required details for preauthorizations or service reviews are captured seamlessly, meeting regulatory and operational needs.
* Considering Request Review Types (Answer C):
* Purpose: UM processes in Health Cloud must address the three primary types of reviews:
* Prior Authorization Review: Conducted before the service is provided to determine medical necessity.
* Concurrent Review: Evaluates the necessity of ongoing care during hospitalization or service delivery.
* Retrospective Review: Analyzes the appropriateness of care after it has been delivered.
* Implementation in Health Cloud:
* The consultant must design workflows and data models to capture the details of these review types, including timestamps, reviewer notes, and outcomes.
* Health Cloud supports tracking and documenting these reviews within the UM module, ensuring compliance with healthcare regulations.
* Relevance: These review types allow the payer to influence decisions by ensuring appropriate care is provided while managing costs and maintaining high-quality outcomes.
Why the Other Options Are Less Relevant:
* A. Designing Next Best Action and Recommendations for the Care Management Team: While recommendations and next-best-action features are beneficial for care management, they are not directly tied to the case-by-case review process of Utilization Management, which focuses more on care appropriateness and authorizations.
* D. Considering the Number of Intake Agents Using Health Cloud: While operational considerations like staffing are important, this is not a Utilization Management process. It's a broader organizational concern unrelated to the core functionality of UM in Health Cloud.
References:
Utilization Management Overview: Salesforce documentation outlines how to handle prior authorizations, service approvals, and related processes within Health Cloud. (help.salesforce.com) Care Requests and Authorizations: Details on managing care requests and integrating with payer systems for streamlined authorization workflows. (developer.salesforce.com) UM Process Design in Health Cloud: Guidance on implementing request review types and managing data models to support UM. (architect.salesforce.com) By addressing Care Requests and Request Review Types, the consultant ensures a robust Utilization Management setup, enabling effective collaboration between payers, providers, and members while optimizing care delivery and compliance.
NEW QUESTION # 50
A payer needs to manage requests for concurrent review of prior authorizations within Health Cloud and wants to use out-of-the-box record types and page layouts for prior However, the payer's Salesforce administrator does not see any preconfigured record types or page layouts for prior authorizations in the payer's Salesforce org.
What should a consultant recommend to the Salesforce administrator to expedite implementation?
Answer: C
Explanation:
* Preconfigured Prior Authorization Objects:
Exact Extract:
"The Health Cloud Care Request Extensions package provides out-of-the-box record types, page layouts, and flows for prior authorizations and other payer workflows." Reference:
* Other Options:
Claims unmanaged package is not for prior authorizations.
Building custom layouts is not necessary when a packaged solution exists.
AppExchange prior authorization packages are not officially supported for core Health Cloud prior auth workflows.
NEW QUESTION # 51
When accessing a person account record within Health Cloud, the user must have access to the entire account.
What should a consultant do in this scenario, according to Health Cloud implementation best practice?
Answer: B
Explanation:
Step-by-Step Explanation:
* Salesforce Health Cloud Best Practice for Person Accounts Access:
* Person Accounts in Salesforce are a combination of an Account and a Contact.
* To ensure thataccess to the person account (patient record) gives access to all data on the record, Salesforce recommends setting theContact sharing setting to "Controlled by Parent".
* This means the sharing and visibility of the Contact (patient details) will follow the sharing settings of the parent Account (the Person Account).
* Salesforce Documentation Reference:
* "For Person Account sharing and access, set the Contact object sharing setting to Controlled by Parent. This ensures that users with access to the Account (Person Account) also have access to the associated Contact data."-Reference: Health Cloud Implementation Guide, Sharing and Access
* Why Not the Other Options?
* A. Set Modify All on the Account object at the Profile level:Too broad; not recommended due to least privilege principle.
* C. Set Private for the Contact object:Would prevent access to the Contact, even if user has access to the Account.
* D. Set the organization-wide default to Public Read Write for the Account object:Not best practice for healthcare, as it risks overexposing sensitive data.
References:
Health Cloud Implementation Guide - Sharing and Access
NEW QUESTION # 52
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