Health-Cloud-Accredited-Professional Salesforce Health Cloud Accredited Professional AP-211 Exam Question and Answers

Step-by-Step Explanation:

Advanced Therapy Management (ATM):For personalized medicine programs, such as those involving apheresis and infusion, Salesforce Health Cloud offers Advanced Therapy Management (ATM), specifically designed for complex therapy coordination.

Exact Extract:

“Advanced Therapy Management supports cell and gene therapy processes by coordinating multiple steps such as collection, manufacturing, apheresis, and infusion.”

Video Visits for Social Determinants of Health (SDOH):

Exact Extract:

“Use Virtual Care in Health Cloud to enable video visits between care providers and patients, including for conversations about social and economic factors.”

To access a patient’s insurance coverage, co-pay, and deductible information in the Benefit Verification component of Health Cloud, you need to integrate with external systems (e.g., payers or clearinghouses). Health Cloud provides the Benefit Verification component, which relies on secure API integrations for real-time eligibility and benefits checks.

Step-by-Step Reference:

Configure the Connection Label with the source system's API details:

Extract:

“In Benefit Verification setup, specify the Connection Label and configure the external endpoint and API details to connect to the benefit verification source system.”

(Source: Administer Health Cloud – Benefit Verification Setup)

Create a named credential to support authenticated callouts:

Extract:

“Use Named Credentials to securely store authentication settings and endpoint information for callouts to external services (such as clearinghouses or payers) required for benefit verification.”

(Source: Salesforce Security Guide and Administer Health Cloud – Benefit Verification)

Why not A or B?

The HCBenVerConnect custom setting is not part of the standard configuration for the out-of-the-box Benefit Verification component.

Configuring a URI path alone (without API details and credentials) does not enable secure, authenticated communication.

Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with References

Provider Search and Performance:

The Data Processing Engine (DPE) in Health Cloud enables fast, scalable searches across large provider directories. It is specifically designed for performance and scalability in Provider Search scenarios.

Extract:

“Health Cloud leverages the Data Processing Engine to deliver scalable, high-performance Provider Search for finding care locations and providers based on patient preferences and proximity.”

— Health Cloud: Provider Search

Other Options:

Pipeline Analytics: Used for data insights, not real-time search.

Business Rules Engine: Handles rules/logic, not high-volume search.

Flow for Industries: Automates processes, but DPE is the correct scalable search tool.

ï‚· FHIR R4 Standard:

Exact Extract:

“Health Cloud supports FHIR R4 as an industry data standard for EHR interoperability.”

When organization-wide default access to patient data is set to Private, Care Team functionality in Health Cloud is the standard, out-of-the-box method to manage individual access to patient records.

Step-by-Step Reference:

Health Cloud uses Care Teams to manage access to patient records.

Extract:

“Add care team members (users, contacts, or person accounts) to the patient’s care team and assign appropriate access (Read or Read/Write) to patient records.”

(Source: Administer Health Cloud - Manage Care Teams)

Administrators can specify the access level (Read or Read/Write) for each care team member, allowing for precise control as per role requirements.

Extract:

“Assign record access levels for care team members when adding them to a patient’s care team. This is especially important when the OWD is set to Private.”

(Source: Administer Health Cloud - Care Team Access)

This ensures compliance and proper segmentation of data, as required by healthcare regulations.

To improve appointment scheduling and provide patient self-service, these three Health Cloud features should be configured:

Experience Cloud for Health Cloud:

Allows creation of patient-facing portals for self-service appointment booking and information access.

Extract:

“Experience Cloud enables self-service portals for patients, supporting appointment scheduling and other interactions.”

(Source: Administer Health Cloud – Experience Cloud)

Intelligent Appointment Management:

Offers advanced scheduling features and automation to reduce wait times and manual booking.

Extract:

“Intelligent Appointment Management in Health Cloud supports both self-service and agent-assisted scheduling workflows.”

(Source: Administer Health Cloud – Intelligent Appointment Management)

Provider Search:

Lets patients find the right clinic or provider based on specialty, availability, and other criteria.

Extract:

“Provider Search empowers patients to search for providers and book appointments online through self-service portals.”

(Source: Administer Health Cloud – Provider Search)

Why not A or D?

Intelligent Form Reader is used for document capture, not for scheduling or self-service.

Assessments and Recommendations are used for care management, not scheduling.

Step-by-Step Explanation:

Requirement Analysis:

The client wants to send patients a personalized summary document after their visit, including their care plan.

The process involves selecting from templates and generating patient-specific content.

Tool Comparison:

Health Cloud Email Manager:

Used for composing and sending emails, not for generating documents from templates.

Salesforce PDF Generator:

While Salesforce can generate PDFs from reports, it does not offer flexible, template-based document generation suited for post-visit summaries or complex care plans, especially with dynamic fields.

OmniStudio Document Generation:

Specifically designed to enable dynamic, template-based document creation in Health Cloud and other Salesforce verticals.

Allows users to select templates, merge patient/case data, and generate PDFs or DOCX that can be sent to patients or caregivers.

Supports integration within Health Cloud flows, empowering users (like a patient advocate) to initiate document generation with a few clicks.

Contract Lifecycle Management:

Focused on legal contracts and workflows, not patient summaries or care plans.

Exact Extracts and References from Salesforce Docs:

Extract from OmniStudio Standard Guide:

“OmniStudio Document Generation lets you generate dynamic documents from templates, such as care plans, patient summaries, or correspondence. Templates can be pre-built and allow for the insertion of Health Cloud data fields, enabling the creation of personalized documents for patients or members.”

— OmniStudio Document Generation Overview

From Health Cloud Admin Guide, under Patient Correspondence:

“Patient advocates can use OmniStudio Document Generation to select templates and create personalized care documents for patients based on their Health Cloud data.”

— Reference: Administer Health Cloud - Document Generation

Best Practice from Salesforce:

Salesforce recommends OmniStudio Document Generation for any scenario requiring dynamic, patient-specific document creation and distribution.

Step-by-Step Explanation:

Salesforce Health Cloud Best Practice for Person Accounts Access:

Person Accounts in Salesforce are a combination of an Account and a Contact.

To ensure that access to the person account (patient record) gives access to all data on the record, Salesforce recommends setting the Contact sharing setting to "Controlled by Parent".

This means the sharing and visibility of the Contact (patient details) will follow the sharing settings of the parent Account (the Person Account).

Salesforce Documentation Reference:

“For Person Account sharing and access, set the Contact object sharing setting to Controlled by Parent. This ensures that users with access to the Account (Person Account) also have access to the associated Contact data.”— Reference: Health Cloud Implementation Guide, Sharing and Access

Why Not the Other Options?

A. Set Modify All on the Account object at the Profile level: Too broad; not recommended due to least privilege principle.

C. Set Private for the Contact object: Would prevent access to the Contact, even if user has access to the Account.

D. Set the organization-wide default to Public Read Write for the Account object: Not best practice for healthcare, as it risks overexposing sensitive data.

To ensure a provider can create and view Salesforce reports analyzing patient outcomes and referrals, the following steps are required:

A. Create custom report types for clinical objects.

Health Cloud clinical data (e.g., patient outcomes, referrals, care plans) resides in custom objects.

To report on them, you must create custom report types.

D. Enable the enhanced Analytics for Healthcare setting in Setup.

This setting provides preconfigured reports and dashboards tailored for healthcare, such as referrals, utilization, and outcomes reporting.

E. Assign appropriate permissions to internal users.

Providers need the correct Health Cloud and reporting permissions to access and run these reports.

Without appropriate object-level and FLS permissions, reports won’t display the necessary data.

Why not the others?

B. Leverage the Patient Referral Management unmanaged package – Referral management is now native in Health Cloud. The unmanaged package was used in early versions but is deprecated and not recommended.

C. Adjust template care management reports and dashboards – These are useful but do not provide referral and outcome reporting by themselves. Customization and proper report type setup are still required.

Salesforce Health Cloud Reference:

🔍 Salesforce Health Cloud Implementation Guide – Reports and Dashboards:

“Enable Enhanced Analytics for Healthcare to access out-of-the-box reports and dashboards for referrals, utilization management, and patient outcomes.”

“Create custom report types for Health Cloud clinical objects to extend reporting capabilities.”

“Ensure users have the appropriate object and field permissions to run reports.

Step 1: Requirement Analysis

The provider’s office needs to verify a patient’s insurance plan information and coverage when a patient calls to book an appointment.

This means checking whether the patient’s insurance is active, what services are covered, and any applicable copays or eligibility details.

Step 2: Health Cloud Out-of-the-Box Capability

Benefits Eligibility and Verification is the dedicated Health Cloud capability that allows provider offices and payers to verify a patient’s insurance coverage, eligibility, and benefit details in real time, either through integration with payers or using Health Cloud workflows.

Extract:

“Health Cloud offers Benefits Eligibility and Verification, enabling providers and payers to confirm a patient’s plan information and coverage eligibility, reducing the risk of denied claims and improving the patient experience.”

Administer Health Cloud – Benefits Eligibility and Verification

Step 3: Review of Options

A. Benefits Eligibility and Verification: Directly addresses insurance plan and coverage verification.

B. Intelligent Appointment Management: For scheduling, not insurance verification.

C. Utilization Management: For prior authorizations and care request reviews.

D. Identity Verification: For confirming patient identity, not insurance coverage.

The Patient Medication Manager component in Salesforce Health Cloud surfaces data from FHIR-aligned medication objects. When customers request field updates on this UI component, the consultant can configure fields from the underlying objects.

A. Medication Details → Stores key information about a patient’s medications. Fields from this object can be exposed or customized on the Patient Medication Manager.

C. Medication Request → Represents a provider’s request or order for a medication. Fields from this object are also available to configure in the Patient Medication Manager.

Together, these two objects form the basis of what’s displayed and editable in the Patient Medication Manager.

Why not the others?

B. Medication Dispense – Tracks when and how a medication was dispensed. It is not directly configurable for field-level updates in the Patient Medication Manager component.

D. Medication Strength – Captures clinical details about dosage strength, but it isn’t one of the configurable objects in the Patient Medication Manager UI.

Salesforce Health Cloud Reference:

🔍 Salesforce Health Cloud Medication Management:

“The Patient Medication Manager component displays information from Medication Details and Medication Request objects. Administrators can add or remove fields from these objects to tailor the component.”

ï‚· Medication Management in Health Cloud enables providers to view all of a patient's prescription history in one place, supporting medication reconciliation and review for better health outcomes.

Extract:

“Use Medication Management to track and review patient prescriptions, past and present, ensuring a comprehensive view of medication history and supporting care team collaboration.”

(Source: Administer Health Cloud – Medication Management)

ï‚· Other options (Intelligent Appointment Management, Virtual Care, Integrated Care Management) do not provide comprehensive medication tracking.

The requirement is to identify the Health Cloud feature that helps ensure compliance with the Health Insurance Portability and Accountability Act (HIPAA), which governs the protection of Protected Health Information (PHI). HIPAA compliance requires robust security measures, including access controls and data protection. Let’s evaluate the options.

Option A: Data visualization and analytics

Explanation: Data visualization and analytics in Health Cloud provide insights into patient data and care coordination but do not directly address HIPAA compliance requirements like securing PHI or controlling access. These features are more about operational efficiency than security.

Expanding Access to Auditors:

Exact Extract:

“Use criteria-based sharing rules to grant additional access to Person Account (patients) records for users or groups who do not own the records, such as auditors.”

After deploying Enhanced Timeline, you must register the custom object to the Timeline before it will appear in the Timeline component on the Lightning page.

Extract:

“Add new objects to the Timeline after deployment in setup, then update the Timeline component to include them.”

(Source: Administer Health Cloud – Enhanced Timeline)

Step-by-Step Explanation:

Intelligent Document Automation:

Exact Extract:

“Intelligent Document Automation in Health Cloud automatically extracts data from incoming documents, including faxes, and creates structured data for downstream workflows.”

Step 1: Requirement

Define workflow for call center users focused on prior authorization status checks.

Step 2: Best Practice for Workflow Discovery

Discovery should be user-centered, involving direct engagement with actual users (personas).

Observing and documenting their daily processes identifies real pain points and optimization opportunities.

Extract:

“Best practice for workflow discovery is to interview and observe key personas, document their processes, and map opportunities for automation and optimization.”

Salesforce Architect – Business Process Discovery

Other options (industry research, previous projects, or proof of concept) do not provide the necessary user insight for workflow design.

Comprehensive Detailed Step by Step Explanation with exact Extracts from Salesforce Health Cloud documents that you have with References

Record Alerts:

Notify agents of important or recent changes in patient information.

Extract:

“Use Record Alerts to keep agents informed of changes and critical updates on the patient’s record.”

— Contact Center for Health Cloud Overview

Timeline:

Provides a single, unified view of all engagement interactions, encounters, and activities with a patient.

Extract:

“Timeline shows a consolidated history of patient interactions and engagement, giving agents a complete view in one place.”

— Health Cloud: Enhanced Timeline

Member Plan FlexCard:

Displays key patient insurance information directly on the record page.

Extract:

“The Member Plan FlexCard displays essential details about the patient’s insurance coverage for agents.”

— OmniStudio: FlexCards

Other Options:

A. Identity Verification: Used for verifying caller identity, not information display.

D. Action Launcher: Launches actions/processes, not for displaying info or alerts.

The use case describes:

A UI component to display customer data → FlexCards

A link to start a process (build a new order) → OmniScript

Retrieving and displaying available products → DataRaptors (and often Integration Procedures if orchestration is needed).

Let’s map it step by step:

D. FlexCards → Used to display contextual customer data on the UI and provide clickable actions (like "Create New Order").

E. OmniScript → Guides the user through the order creation process, step by step (product selection, details, confirmation).

A. DataRaptors → Extract and load Salesforce data (e.g., retrieving available products, saving the order).

👉 These three are the core capabilities needed.

Why not the others?

B. Integration Procedures – Helpful if the solution requires multiple data sources or orchestration, but the question doesn’t explicitly state external integration or complex orchestration. If data is all within Salesforce, DataRaptors are enough.

C. Document Generation – Used to create documents (PDFs, Word, etc.), which isn’t part of this order creation flow.

Salesforce Health Cloud / OmniStudio Reference:

🔍 Salesforce OmniStudio Developer Guide

“FlexCards present contextual information and actions in a UI component.”

“Use OmniScripts to guide users through business processes such as creating orders.”

“DataRaptors retrieve, transform, and save Salesforce data for use in OmniScripts and FlexCards.”

The requirement is:

Push patient medication updates to an external pharmacy immediately → This is an event-driven use case.

Receive immediate confirmation about medication interactions from the pharmacy → This requires a synchronous call/response pattern.

The correct integration patterns are:

A. Platform Event

Best for real-time, event-driven notifications when medication information is updated in Health Cloud.

Ensures the pharmacy receives updates as soon as they occur.

D. Apex HTTP Callout

Supports synchronous communication with external systems.

Allows Health Cloud to send a request and receive an immediate confirmation/response about medication interactions from the pharmacy.

Why not the others?

B. Industries ETL – This is for batch, large-volume data movement, not real-time event-driven updates or immediate confirmations.

C. OmniStudio Integration Procedure – Great for orchestrating data retrieval/manipulation across systems, but it’s not designed for event-driven updates with confirmation requirements.

Salesforce Health Cloud Reference:

🔍 Salesforce Integration Patterns and Practices:

“Use Platform Events for event-driven, near real-time messaging between Salesforce and external systems.”

“Use Apex callouts when Salesforce must send a request and wait for an immediate response.”

Step-by-Step Explanation:

Health Cloud Intelligent Document Automation (IDA) Capabilities:

IDA automates processing of incoming documents (like insurance cards or clinical records).

Out-of-the-box features allow:

Document Rotation: For correcting the orientation of scanned/received documents.

Record Type Association: For matching documents to appropriate Salesforce record types (such as associating a document with a Patient or Encounter).

Automated Document Checklist Item Creation: Automatically creating checklist items for actions (e.g., missing forms or needed verifications).

Supported and Unsupported Features:

Barcode Scanning: Not an out-of-the-box feature of Health Cloud IDA (may require third-party solutions).

eFax Connection: While Health Cloud supports document management, direct eFax integration is not out-of-the-box.

Official Document Extracts:

From Salesforce Help:

“You can rotate, associate, and automate checklist items for documents received in Health Cloud using Intelligent Document Automation.”

— Administer Health Cloud – Document Automation

In Salesforce Health Cloud, when dealing with prior authorizations, the correct data model objects are:

Service Preauth → Represents the overall prior authorization request (at the header level).

Preauth Detail → Captures the individual service line items or outcomes associated with the prior authorization.

This structure allows Health Cloud to integrate with an external utilization management system that handles the full prior authorization process. The Service Preauth object acts as the container for the request, while Preauth Detail records capture outcomes, decisions, and details returned from the external system.

This is exactly suited to the requirement:

“The provider requires a display of preauthorization outcomes from its external system which manages the end-to-end prior authorization process.”

Why not the others?

A. Plan Benefit and Plan Benefit Item – These are used to model insurance plan coverage and benefits, not authorization workflows.

B. Care Preauth and Care Preauth Item – These are older, deprecated objects in favor of the Service Preauth data model.

D. Care Request and Care Request Item – These are used to track referrals and service requests (e.g., a doctor requesting lab work), but not prior authorization outcomes.

Salesforce Health Cloud Reference:

🔍 Salesforce Health Cloud Developer Guide – Utilization Management Data Model:

“The Service Preauth object represents the prior authorization request and its details. The Preauth Detail object contains service line items and outcomes for the prior authorization request.”

Salesforce Help: Utilization Management Data Model

Salesforce Health Cloud Implementation Guide – Prior Authorizations

Step-by-Step Explanation:

CRM Analytics for Health Cloud:

Exact Extract:

“CRM Analytics for Health Cloud delivers prebuilt dashboards and extended analytics for monitoring care plans, outcomes, and adherence across networks and facilities.”