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Question 142 - Certified Health Cloud Accredited Professional discussion

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A health plan provider would like to manage prior authorizations with predefined approval criteri

a. Which three features in Health Cloud should a consultant recommend in this case?

A.
Claims data model
Answers
A.
Claims data model
B.
Business Rules Engine
Answers
B.
Business Rules Engine
C.
Utilization Management data model
Answers
C.
Utilization Management data model
D.
Intelligent Appointment Management
Answers
D.
Intelligent Appointment Management
E.
Out-of-the-box Process libraries
Answers
E.
Out-of-the-box Process libraries
Suggested answer: B, C, E

Explanation:

The three features in Health Cloud that the consultant should recommend to the health plan provider are Business Rules Engine, Utilization Management data model, and Out-of-the-box Process libraries. These features enable the provider to manage prior authorizations with predefined approval criteria, store and track care requests, and leverage best practices and templates for common scenarios .

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asked 23/09/2024
Juliet Kihonge
43 questions
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