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Question 176 - Certified Health Cloud Accredited Professional discussion

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A provider is looking to implement Utilization Management in Health Cloud and submit and track prior authorizations. Which two capabilities should a consultant customize to achieve this?

A.
Create a new UtilizationManagementSettings record in Custom Settings.
Answers
A.
Create a new UtilizationManagementSettings record in Custom Settings.
B.
Create a new Support Process to match the customer's process steps.
Answers
B.
Create a new Support Process to match the customer's process steps.
C.
Integrate using MuleSoft Direct for electronic Prior Authorizations (ePA).
Answers
C.
Integrate using MuleSoft Direct for electronic Prior Authorizations (ePA).
D.
Customize the Service Request object.
Answers
D.
Customize the Service Request object.
Suggested answer: B, D

Explanation:

The two capabilities that a consultant should customize to implement Utilization Management in Health Cloud and submit and track prior authorizations are creating a new Support Process to match the customer's process steps and customizing the Service Request object. A Support Process defines the picklist values available for the Status field on a Service Request record, which represents a prior authorization request. The consultant can create a new Support Process to match the customer's process steps, such as Submitted, Approved, Denied, or Pending. The Service Request object stores information about the prior authorization request, such as the patient, the provider, the service type, and the outcome. The consultant can customize this object by adding or removing fields, creating validation rules, or defining page layouts.

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asked 23/09/2024
Charles Smith
44 questions
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