Salesforce Health-Cloud-Accredited-Professional - Salesforce Health Cloud Accredited Professional Exam (SP25)

Video Visits for Social Determinants of Health (SDOH):

Exact Extract:

“Use Virtual Care in Health Cloud to enable video visits between care providers and patients, including for conversations about social and economic factors.”

Step-by-Step Explanation:

Discovery Framework for PROMs Surveys:The Discovery Framework in Health Cloud supports question banks, standardized survey templates, and version control.

Exact Extract:

“Use the Discovery Framework to create assessments with question banks, reusable questions, and versioning to manage standardized surveys such as PROMs.”

ï‚· Medication Managementin Health Cloud enables providers to view all of a patient's prescription history in one place, supporting medication reconciliation and review for better health outcomes.

Extract:

“Use Medication Management to track and review patient prescriptions, past and present, ensuring a comprehensive view of medication history and supporting care team collaboration.”

(Source: Administer Health Cloud – Medication Management)

ï‚· Other options (Intelligent Appointment Management, Virtual Care, Integrated Care Management) do not provide comprehensive medication tracking.

ï‚· Tracking Socioeconomic & Cultural Barriers:

Exact Extract:

“The Social Determinants of Health data model in Health Cloud enables organizations to document and track social, cultural, and economic barriers affecting patients.”

Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with References

Healthcare Practitioner and Healthcare Provider Objects:

Salesforce recommends using theHealthcare Practitionerobject for modeling individual doctors and theHealthcare Providerobject 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. ContactandB. Person Accountare not the recommended approach for modeling licensed clinical professionals in the Health Cloud provider data model.

Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with References

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.

ï‚· FHIR-Based Interoperability with Transformation:

Exact Extract:

“Middleware solutions enable integration with EHRs using HL7 or FHIR standards and can perform necessary data transformation for compatibility with Health Cloud.”

Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with References

Request Review Types:

Utilization Management processes center around reviewing requests for appropriateness of care, with the three main types beingPrior Authorization Review, Concurrent Review, and Retrospective Review.

Extract:

“Utilization Management supports prior authorization, concurrent, and retrospective reviews to evaluate care appropriateness case by case.”

—Utilization Management in Health Cloud

Care Requests:

Care Requests are the mechanism for providers to seek authorization from payers for drugs, services, or admissions.

Extract:

“Design care request processes to support providers seeking health plan authorization for services, medications, or admissions.”

—Health Cloud Utilization Management Data Model

Why not the other options?

A:Next Best Action is more for care management recommendations, not utilization review.

C:Intake agent count is an operational consideration, not a UM process.