QUESTION: 57

The Salesforce administrator for ABC Policies Inc, a Health Care Payer Organization, would like to enable the members to enroll in and out of Care Program multiple times.
Where, within Health Cloud Settings, should a Health Cloud administrator make changes to accomplish this requirement?

Program Enrollee Settings
Care Program Settings
Health Cloud Settings
Care Request Settings

Answer(s): A

Explanation:

According to the Health Cloud Implementation Guide, Program Enrollee Settings is the place within Health Cloud Settings where a Health Cloud administrator can make changes to accomplish the requirement of enabling the members to enroll in and out of Care Program multiple times. Program Enrollee Settings allow the administrator to configure how members can be enrolled in or removed from care programs, such as allowing multiple enrollments, setting enrollment statuses, and defining enrollment criteria. Care Program Settings, Health Cloud Settings, and Care Request Settings are not places where the administrator can make changes to enable multiple enrollments.

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QUESTION: 58

Which two of the following statements are true about Care Teams? (Choose Two.)

Care Team Members are optional on a Care Plan.
A Care Plan must have a Coordinator as a member of the Care Team before a Care Plan Template can be applied.
If the Problem and Goal objects use Private Sharing, Care Team Membership provides access to these objects.
Communities must be enabled before External Care Team members can be added.

Answer(s): A,B

Explanation:

According to the Health Cloud Implementation Guide, two statements that are true about Care Teams are:
Care Team Members are optional on a Care Plan. This statement is true because a care plan can be created without any care team members assigned to it. However, adding care team members can help with collaboration and coordination of care.

A Care Plan must have a Coordinator as a member of the Care Team before a Care Plan Template can be applied. This statement is true because a coordinator is required to manage the tasks and goals of a care plan template. A coordinator can be either an internal or external user who has access to Health Cloud. If the Problem and Goal objects use Private Sharing, Care Team Membership provides access to these objects is not a true statement, as care team membership does not grant access to objects that use private sharing. Communities must be enabled before External Care Team members can be added is not a true statement, as external care team members can be added without enabling communities.

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QUESTION: 59

A Health Cloud administrator has set up risk recalculation by setting the recalculate flag to TRUE but is not seeing the recalculation score for the patient.
Which of the following is most likely the reason why recalculation score for the patient is not displaying?

Use the CMS recalculation API
Risk scores are only recalculated for patients who are affiliated with a care program.
CMS scores cannot be recalculated in health cloud.
Use a 3 - Apply to Real World / Analyze / Evaluated party API to recalculate CMS risk score.

Answer(s): B

Explanation:

According to the Health Cloud Data Model Developer Guide, Risk scores are only recalculated for patients who are affiliated with a care program is the most likely reason why recalculation score for the patient is not displaying. Risk scores are calculated based on CMS-HCC (Centers for Medicare & Medicaid Services - Hierarchical Condition Categories) model, which assigns risk factors to patients based on their diagnoses and demographic factors. Risk scores are used to adjust payments for health plans and providers. Risk scores are only recalculated when the recalculate flag is set to TRUE and the patient is affiliated with a care program. Using CMS recalculation API is not a valid reason, as CMS recalculation API is not a feature of Health Cloud. CMS scores cannot be recalculated in health cloud is not a valid reason, as CMS scores can be recalculated in health cloud by setting the recalculate flag to TRUE. Using a third party API to recalculate CMS risk score is not a valid reason, as it has nothing to do with displaying the recalculation score.

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QUESTION: 60

Which Salesforce object is used to model a Care Plan?

Account
Lead
Case
Opportunity
Task

Answer(s): C

Explanation:

According to the Health Cloud Data Model Developer Guide, Case is the Salesforce object that is used to model a Care Plan. Case is a standard object that represents an issue or request that requires resolution or action. Cases can be used to model care plans by adding custom fields and related objects such as problems, goals, tasks, and timeline events. Account, Lead, Opportunity, and Task are not objects that are used to model a Care Plan.

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QUESTION: 57

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QUESTION: 58

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QUESTION: 59

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QUESTION: 60

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