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Question 139 - Certified Health Cloud Accredited Professional discussion

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A payer needs to implement a program to address the rising healthcare expenses and ensure affordable care for its members. The payer aims to strike a balance between quality care and managing the cost of care effectively by streamlining its approval processes for care requests.

Which capability in Health Cloud helps the payer accomplish this?

A.
Provider Network Management
Answers
A.
Provider Network Management
B.
Intelligent Appointment Management
Answers
B.
Intelligent Appointment Management
C.
Utilization Management
Answers
C.
Utilization Management
D.
Integrated Care Management
Answers
D.
Integrated Care Management
Suggested answer: C

Explanation:

Utilization Management is the capability in Health Cloud that helps the payer accomplish its goal of balancing quality care and managing the cost of care effectively. It enables the payer to streamline its approval processes for care requests using predefined rules and workflows.

asked 23/09/2024
Karanshah Gulati
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