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Salesforce Health Cloud Accredited Professional Sample Questions (Q69-Q74):

NEW QUESTION # 69
A pharma company wants to leverage Provider Search to help patients find nearby infusion clinics.
Which Health Cloud tool should a consultant leverage to drive performance and scalability?

Answer: A

Explanation:
Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with Reference Provider Search and Performance:
The Data Processing Engine (DPE) in Health Cloud enables fast, scalable searches across large provider directories. It is specifically designed for performance and scalability in Provider Search scenarios.
Extract:
"Health Cloud leverages the Data Processing Engine to deliver scalable, high-performance Provider Search for finding care locations and providers based on patient preferences and proximity."
- Health Cloud: Provider Search
Other Options:
Pipeline Analytics: Used for data insights, not real-time search.
Business Rules Engine: Handles rules/logic, not high-volume search.
Flow for Industries: Automates processes, but DPE is the correct scalable search tool.
Reference:
Health Cloud: Provider Search


NEW QUESTION # 70
A health plan provider would like to manage prior authorizations with predefined approval criteria.
Which three features in Health Cloud should a consultant recommend in this case?
Choose 3 answers

Answer: C,D,E

Explanation:
Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with Reference Business Rules Engine (BRE):
Enables you to define, automate, and manage approval criteria for prior authorizations.
Extract:
"Use Business Rules Engine to automate decisions and apply approval criteria for utilization management and prior authorizations."
- OmniStudio: Business Rules Engine
Utilization Management Data Model:
Provides standard Health Cloud objects to manage prior authorizations, including requests, approvals, and denials.
Extract:
"Health Cloud Utilization Management provides a complete data model for tracking prior authorization requests and decisions."
- Health Cloud: Utilization Management Data Model
Out-of-the-box Process Libraries:
Prebuilt processes for common healthcare workflows, including prior authorizations.
Extract:
"Out-of-the-box process libraries provide reusable flows for utilization management, including authorizations, appeals, and notifications."
- Administer Health Cloud: Process Libraries
Incorrect Options:
A . Claims data model: Related to claims, not prior authorizations.
B . Intelligent Appointment Management: Focused on scheduling, not utilization management or prior authorization.
Reference:
OmniStudio: Business Rules Engine
Health Cloud: Utilization Management Data Model
Administer Health Cloud: Process Libraries


NEW QUESTION # 71
Care managers at Bloomington Caregivers call patients after they are discharged from a hospital to ask a series of questions, which the care manager enters into Health Cloud. The patient is then automatically assigned a personalized care plan based on the answers they provided.
Which two capabilities should a consultant leverage together to fulfill this requirement?
Choose 2 answers

Answer: A,D

Explanation:
The scenario involves collecting structured information (series of questions) from patients and automatically assigning a personalized care plan based on their answers.
Step-by-Step Reference:
Salesforce Surveys can be used to gather responses from patients post-discharge.
Extract:
"With Salesforce Surveys, care managers can send and record responses directly within Health Cloud, allowing structured data capture from patients." (Source: Administer Health Cloud - Surveys) Discovery Framework processes responses and triggers automated care plan assignments based on responses.
Extract:
"The Discovery Framework in Health Cloud enables dynamic question flows and recommendations, such as assigning care plans based on patient answers." (Source: Administer Health Cloud - Discovery Framework) Combining these, care managers can capture structured data (Surveys) and drive workflow automation and personalization (Discovery Framework).


NEW QUESTION # 72
A payer receives faxes for clinical review as part of the determination process. The payer needs Health Cloud to automatically capture the data from the documents received from patients and manage the end-to-end approval process.
Which two Health Cloud capabilities should a consultant recommend as a way to build this process?
Choose 2 answers

Answer: A,D

Explanation:
Step-by-Step Explanatio n:
Intelligent Document Automation:
Exact Extract:
"Intelligent Document Automation in Health Cloud automatically extracts data from incoming documents, including faxes, and creates structured data for downstream workflows." Reference:
Utilization Management:
Exact Extract:
"Utilization Management provides workflows and automation to support end-to-end approval processes, including clinical review and authorizations." Why Not Other Options?
Integrated Care Management: Focuses on care plans and assessments, not document automation or clinical approval processes.
Care Authorizations: Part of Utilization Management but not the capability for document ingestion and process automation.


NEW QUESTION # 73
A payer is looking for a solution to recruit, credential, and onboard providers into its network.
Which Health Cloud add-on should help the payer address these requirements?

Answer: D

Explanation:
Step 1: Understanding the Requirement
A payer organization needs to recruit, credential, and onboard providers into its network. This requires features that manage provider information, credentialing processes, onboarding workflows, and network directory maintenance.
Step 2: Official Salesforce Health Cloud Capability
Salesforce Health Cloud offers an add-on called Provider Network Management (PNM) that is specifically designed for payers to recruit, credential, and onboard providers.
Extract:
"Provider Network Management streamlines recruiting, credentialing, onboarding, and network directory maintenance for payers. It provides tools to manage the provider lifecycle from initial recruitment through onboarding and network management." Administer Health Cloud - Provider Network Management Step 3: Review of Options A . Contact Center for Payers: Focused on member and provider service center functionality, not recruiting or credentialing.
B . Utilization Management: Focused on authorization and medical necessity reviews, not onboarding or credentialing.
C . Provider Network Management: Specifically built for recruiting, credentialing, and onboarding providers.
D . Provider Relationship Management: Focuses on relationship management post-onboarding, but not credentialing/onboarding workflows.
Reference:
Provider Network Management in Health Cloud


NEW QUESTION # 74
......

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