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NEW QUESTION 25
Care Requests seek authorization from a health plan for drugs, services, and admissions. They can also contain request for review, appeals, complaints and grievances. Which Care Request review ensure that a member is getting the right care in timely and cost-effective way?

A. Disposition ReviewB. Preauthorization ReviewC. Care ReviewD. Concurrent ReviewE. Retrospective Review

Answer: C

 

NEW QUESTION 26
Which two health cloud specific setting must be configuration .......... Health cloud org has lightning experience enabled person account......... (Choose two)

A. Enable "Use Person Accounts" custom setting.B. Under Custom Metadata Types, enable the Health cloud SettingC. Disable "Use Individual Data Model" in custom settingD. Under Custom Metadata Types, Update the Health cloud 'HCFeature'...E. Under Custom Metadata Types, Create a mapping records for Person accounts.

Answer: A,E

 

NEW QUESTION 27
How Should Members and Patients be represented during the............ Managers as per the Salesforce recommendation?

A. Salesforce recommends using Member Accounts to represent members ......B. Leveraging Person Accounts is the recommended approach to .........C. The individual Data Model may be used to represent members .........D. Leveraging Candidate Accounts are the recommended approach to .........

Answer: B

 

NEW QUESTION 28
In which two ways can an administrator ensure that Patient Risk scores are recalculated periodically? (Choose Two.)

A. Use a third party API to recalculate CMS risk scoreB. Setup a scheduled Apex batch job.C. Use the CMS recalculation APID. Create a Healthcare Provider enrollment flow.E. Setup a Apex batch job and run the job manually

Answer: B,E

Explanation:
Reference and details below.

 

NEW QUESTION 29
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