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Salesforce Health Cloud Accredited Professional Sample Questions (Q90-Q95):
NEW QUESTION # 90
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?
- A. Utilization Management
- B. Contact Center for Payers
- C. Provider Relationship Management
- D. Provider Network Management
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 # 91
Bloomington Caregivers has more than 1 million patients and each patient has an average of 10 claims a year, which are maintained in an external claims system. Management would like their agents to view all the claims of patients in Salesforce on demand when they open the patient's record.
What should a consultant recommend as the appropriate integration pattern to achieve this?
- A. Configure the claims system as an external data source and leverage external objects with the claims data.
- B. Add a nightly job to fetch all the claims from the external system and store them in Salesforce.
- C. Make a callout on demand to the external system and store the claims data against the patient record.
- D. Use an Enterprise Service Bus (ESB) to load all the claims data from the external system into Salesforce.
Answer: C
NEW QUESTION # 92
Bloomington Caregivers is looking to view potential drug-to-drug interactions for its patients' medications and make recommendations based on that data within Health Cloud.
Which Health Cloud add-on should a consultant recommend to fulfill this requirement?
- A. Medication Management
- B. RxNorm DDI Connectivity
- C. Medication Interactions
- D. Allergy Intolerance
Answer: A
Explanation:
Step 1: Requirement Analysis
Bloomington Caregivers wants to view potential drug-to-drug interactions for patients' medications and make recommendations based on that data within Health Cloud.
Step 2: Health Cloud Add-On for Drug Interaction
The Medication Management add-on in Salesforce Health Cloud is specifically designed to handle comprehensive medication tracking, including the ability to surface potential drug-to-drug interactions and provide recommendations for care teams.
Extract:
"With Health Cloud Medication Management, you can track all of a patient's prescribed and OTC medications, receive potential drug-drug interaction alerts, and use this data to provide recommendations and clinical guidance." Administer Health Cloud - Medication Management Medication Interactions and RxNorm DDI Connectivity are not standalone Salesforce Health Cloud add-ons; the capability is delivered as part of the broader Medication Management feature set.
Allergy Intolerance is used to track allergy data, not drug interactions.
NEW QUESTION # 93
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?
- A. Utilization Management
- B. Identity Verification
- C. Intelligent Appointment Management
- D. Benefits Eligibility and Verification
Answer: D
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 # 94
A clinic is looking to manage its associated physicians within Health Cloud.
Which two objects support Salesforce's recommended approach to model the doctors in the clinic's Health Cloud org?
Choose 2 answers
- A. Healthcare Provider
- B. Healthcare Practitioner
- C. Person Account
- D. Contact
Answer: A,B
Explanation:
Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with Reference Healthcare Practitioner and Healthcare Provider Objects:
Salesforce recommends using the Healthcare Practitioner object for modeling individual doctors and the Healthcare Provider object for organizations/facilities.
Extract:
"Model physicians using the Healthcare Practitioner object and relate them to organizations or facilities using the Healthcare Provider object."
- Provider Network Management Data Model
Other Options:
A . Contact and B. Person Account are not the recommended approach for modeling licensed clinical professionals in the Health Cloud provider data model.
Reference:
Provider Network Management Data Model
NEW QUESTION # 95
......
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