Free Salesforce Health-Cloud-Accredited-Professional Practice Exam with Questions & Answers | Set: 4

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.