Questions for the HEALTH CLOUD ACCREDITED PROFESSIONAL were updated on : Dec 01 ,2025
A provider's office wants to verify a patient's insurance plan information and coverage when they call
into the call center to book an appointment.
Which capability should a consultant leverage to address this requirement?
A
Explanation:
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.
Bloomington Caregivers has created and tested its first care plan template in sandbox, which includes
problems, goals, and tasks. The company has deployed this template to its final environment using
Data Loader.
Which two steps should a consultant recommend, following this deployment, to enable users to
successfully leverage this new template?
Choose 2 answers
A, C
Explanation:
Step 1: Requirement Analysis
After deploying a care plan template (including problems, goals, and tasks) via Data Loader to the
final environment, users must be able to use the new template for creating care plans in production.
Step 2: Salesforce Health Cloud Documentation Guidance
According to the official Health Cloud administration guide, two key post-deployment steps are
required:
1. Confirm User Access to Care Plan Objects
Users must have the correct permissions to view, create, and use care plan templates and related
records. This involves assigning the appropriate permission sets or profiles to allow access to the
Care Plan, Care Plan Template, and related objects.
Extract:
“Ensure users have the necessary permissions to access care plan templates and related objects so
they can view and apply templates to patients’ care plans.”
Administer Health Cloud – Care Plans and Permissions
2. Activate the New Care Plan Template
Templates (and their related records) must be activated after being deployed to make them available
for use by end users. Care plan templates in Salesforce Health Cloud have an “Active” status that
must be set to “True” or “Activated” before users can select them when creating new care plans.
Extract:
“After importing care plan templates and related data, administrators must activate the template to
make it available to care coordinators and clinicians.”
Administer Health Cloud – Deploying and Activating Care Plan Templates
Other Options:
B . Activate the problems, goals, and tasks associated with the template:
Not required as a separate step. When you activate the care plan template, its associated problems,
goals, and tasks become available.
D . Conduct end-user training:
While important, it is not a required technical step for enabling the template after deployment.
Verified Answers:
A . Confirm User access to Care Plan objects.
C . Activate the new care plan template.
Reference:
Administer Health Cloud – Care Plan Templates
Administer Health Cloud – User Setup
How should a consultant recommend modeling a physician's locations of service, when the physician
practices at multiple hospitals and clinics?
C
A consultant is working with an insurance provider to set up prior authorizations in Health Cloud. The
provider requires a display of preauthorization outcomes from its external system which manages
the end-to-end prior authorization process.
Which solution is appropriate to meet this use case?
C
Explanation:
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
Bloomington Caregivers has replaced its legacy Contact Center application with Health Cloud. During
user acceptance testing (UAT), the call center team Is reporting differences between current Identity
Verification business processes and what was
built in Health Cloud.
The call center manager has requested the following changes:
* Birth Date be available in results and as an optional verifier, but no longer required for verification
purposes
* Add ‘Bloomington ID', a custom field on Account, to search results and as a required verifier
What should a consultant do to meet these requirements?
C
Explanation:
Step 1: Requirement Analysis
Birth Date should be a result field and an optional verifier (not required).
Bloomington ID (a custom field) should appear in search results and be a required verifier.
Step 2: Salesforce Health Cloud Identity Verification Process Configuration
The Identity Verification Process Field object in Health Cloud determines which fields are used for
search results, required verification, or optional verification during the identity verification process.
You can add multiple records for a field with different purposes (e.g., one as Result Field and another
as Required/Optional Verifier).
Extract:
“You can add or modify Identity Verification Process Field records to control which fields are shown
as search results, required verifiers, or optional verifiers. For example, to make a field a required
verifier, set Field Type to ‘Required Verifier’. To make a field show in results, set Field Type to ‘Result
Field’. You can have more than one record for the same field with different Field Types.”
Administer Health Cloud – Identity Verification Process
Step 3: Actions Needed
For Bloomington ID:
Add a record with Field Type = Result Field (to display in search results)
Add another record with Field Type = Required Verifier (to make it a required field for verification)
For Birth Date:
Update the current record so that Field Type is changed from Required Verifier to Optional Verifier
(to make it not required but still usable as a verifier)
Ensure there is a record with Field Type = Result Field if Birth Date should show in the results
Step 4: Review of Options
A: Incorrect; it says to delete the Birth Date Required Verifier instead of changing it to optional.
B: Not the right object/method; doesn’t mention the correct object (Identity Verification Process
Field).
C: Correct; matches the best practices and object structure in Health Cloud.
D: Incomplete; does not cover all configuration requirements.
Verified Answer:
C . Add two new Identity Verification Process Field records for ‘Bloomington one with Field Type set
to Result Field and one with Field Type set to Required Verifier. Change the Birth Date record with
Field Type value Required Verifier to Optional Verifier.
Reference:
Health Cloud Identity Verification Process Setup
A consultant is implementing Identity Verification for their customer's customer service
representatives and needs to add a new search parameter.
Which record should the consultant configure to accomplish this?
C
Explanation:
In Salesforce Health Cloud’s Identity Verification framework, you can configure which search
parameters (such as date of birth, SSN, phone number, etc.) are used by customer service
representatives to verify a member or patient’s identity.
To add a new search parameter, you configure an Identity Verification Parameter Item record.
Identity Verification Parameter Item → Defines the actual search fields that will be used in the
verification process.
These parameter items are tied to the Identity Verification Process Detail to determine how the
verification is performed.
Why not the others?
A . Verification Search Feature – This controls whether identity verification search is enabled, but not
the specific search parameters.
B . Identity Verification Process Detail – This defines the steps and rules of the verification process,
but doesn’t store the search fields themselves.
D . Linked Identity Search Detail – Used to configure linked identities across systems, not to add new
search parameters.
Salesforce Health Cloud Reference:
Salesforce Help – Identity Verification in Health Cloud
“To configure the search fields that agents use for member or patient identity verification, create and
manage Identity Verification Parameter Item records.”
Salesforce Health Cloud Identity Verification Documentation
A payer is implementing Health Cloud and wants to leverage predefined rules for its prior
authorization request review process. The payer would like to leverage out-of-the-box Health Cloud
functionality to drive speed to value.
Which prebuilt feature should a consultant recommend the payer leverage?
B
Explanation:
Step 1: Requirement Analysis
The payer wants to use predefined rules for prior authorization request reviews, seeking out-of-the-
box Health Cloud functionality for speed to value.
Step 2: Health Cloud Prior Authorization & Rules Engine
The Expression Set Templates in Health Cloud provide a prebuilt, configurable framework to
automate and standardize prior authorization request reviews. These templates contain reusable
logic and criteria that can be easily tailored and applied to common authorization scenarios.
Extract:
“Use Health Cloud’s prebuilt Expression Set Templates to accelerate prior authorization
configuration. These templates enable payers to implement standardized review criteria and
automate decision logic without building rules from scratch.”
Administer Health Cloud – Utilization Management and Expression Sets
Integration Procedures, FlexCards, and OmniScript Templates are OmniStudio tools for integration,
UI, and guided processes, but Expression Set Templates are the feature specifically designed for rules
automation in Utilization Management.
Bloomington Caregivers is looking to view potential drug-to-drug interactions for its patients'
medications and make recommendations based on that data within Health Cloud.
Which Health Cloud add-on should a consultant recommend to fulfill this requirement?
D
Explanation:
Step 1: Requirement Analysis
Bloomington Caregivers wants to view potential drug-to-drug interactions for patients' medications
and make recommendations based on that data within Health Cloud.
Step 2: Health Cloud Add-On for Drug Interaction
The Medication Management add-on in Salesforce Health Cloud is specifically designed to handle
comprehensive medication tracking, including the ability to surface potential drug-to-drug
interactions and provide recommendations for care teams.
Extract:
“With Health Cloud Medication Management, you can track all of a patient’s prescribed and OTC
medications, receive potential drug-drug interaction alerts, and use this data to provide
recommendations and clinical guidance.”
Administer Health Cloud – Medication Management
Medication Interactions and RxNorm DDI Connectivity are not standalone Salesforce Health Cloud
add-ons; the capability is delivered as part of the broader Medication Management feature set.
Allergy Intolerance is used to track allergy data, not drug interactions.
A customer wants to view and navigate to critical insurance, clinical, and primary care physician
information on a patient's profile.
Which Health Cloud capability should a consultant implement?
C
Explanation:
In Salesforce Health Cloud, when a customer wants to view and navigate to critical patient
information such as insurance, clinical, and primary care physician details, the right feature to
implement is the Advanced Patient Card.
The Advanced Patient Card provides a configurable panel that displays key patient information at a
glance directly on the patient’s profile.
It allows quick navigation to related records (insurance coverage, care team/PCP, clinical info, etc.)
without switching pages.
It’s specifically designed to give providers and service representatives a 360-degree view of the
patient’s most important details.
Why not the others?
A . Enhanced Highlights Panel – This is a general Salesforce feature to show record highlights, but it’s
not tailored to healthcare-specific patient insights.
B . Enhanced Timeline – Useful for viewing chronological events (interactions, activities, encounters),
but not for quick access to insurance/PCP details.
D . Patient Path – This is a visual guide for patient journeys or care programs, not for surfacing key
profile details.
Salesforce Health Cloud Reference:
Salesforce Health Cloud Implementation Guide – Advanced Patient Card:
“Use the Advanced Patient Card to display a patient’s most critical information—such as coverage,
conditions, medications, and care team members—directly on the patient profile for easy reference
and navigation.”
Salesforce Help: Advanced Patient Card
Bloomington Caregivers wants to ensure it maintains the privacy of its users’ data by enabling data
protection details for leads, contacts, and person accounts during the initial Health Cloud install and
configuration.
Which entity should the administrator enable within Data Protection and Privacy for Health Cloud to
work in this scenario?
C
A customer wants to view medication data from Health Cloud leveraging FHIR standards.
Which Health Cloud data model should a consultant use?
C
An agent at a MedTech company requires a UI component that displays customer data and contains a
link to create a new order. Once clicked, the link starts a process to build a new order and displays the
available products for purchase.
Which three OmniStudio capabilities are required to solve this use case?
Choose 3 answers
A, D, E
Explanation:
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.”
Which Health Cloud feature helps ensure compliance with Health Insurance Portability and
Accountability Act (HIPAA) regulations?
C
Explanation:
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
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.
Reference: Salesforce Health Cloud Admin Guide, “Analytics and Dashboards,” states, “Data
visualization and analytics help providers gain insights but do not include security features for HIPAA
compliance.”
Option B: Real-time monitoring and alerts
Real-time monitoring and alerts in Health Cloud track patient conditions or system events (e.g.,
missed appointments). While useful for care delivery, they do not directly enforce HIPAA’s security
requirements, such as access control or encryption of PHI.
Reference: Salesforce Health Cloud Admin Guide, “Monitoring and Alerts,” notes, “Real-time
monitoring supports care coordination but is not designed for HIPAA security compliance.”
Option C: User authentication and access control
User authentication and access control are critical Health Cloud features that ensure only authorized
users can access PHI, a core requirement of HIPAA. Health Cloud leverages Salesforce’s robust
security model, including role-based access, profiles, permission sets, and multi-factor
authentication (MFA), to protect sensitive data. The Salesforce Security Guide explicitly links these
features to HIPAA compliance.
Step-by-Step
User Authentication: Health Cloud requires users to authenticate via secure methods (e.g.,
username/password, MFA) to access the system.
Access Control: Administrators configure roles, profiles, and permission sets to restrict access to PHI
based on the principle of least privilege.
Auditing: Health Cloud supports audit trails to track access and changes to PHI, ensuring traceability.
Compliance: These features align with HIPAA’s requirements for administrative safeguards (e.g.,
access management) and technical safeguards (e.g., authentication).
Reference:
Salesforce Security Guide, “HIPAA Compliance,” states, “Salesforce Health Cloud supports HIPAA
compliance through user authentication, access controls, and audit capabilities to protect PHI.”
Salesforce Health Cloud Admin Guide, “Security and Compliance,” notes, “User authentication and
access control ensure that only authorized personnel access sensitive patient data, aligning with
HIPAA requirements.”
Option D: Social media integration
Social media integration is not a Health Cloud feature and is irrelevant to HIPAA compliance. Sharing
PHI on social media would violate HIPAA regulations, and Health Cloud does not support such
functionality.
Reference: Salesforce Security Guide, “Best Practices for PHI,” warns, “PHI must not be shared on
unsecured platforms, including social media, to comply with HIPAA.”
Why Option C is Correct:
HIPAA mandates strict controls on who can access PHI, and user authentication and access control in
Health Cloud directly address this by ensuring secure, role-based access to sensitive data. These
features are foundational to Salesforce’s HIPAA compliance strategy, as outlined in the Security
Guide.
Additional Considerations:
Shield Platform Encryption: While not listed as an option, Health Cloud can use Shield Platform
Encryption to further protect PHI, complementing access controls.
Audit Trails: The Salesforce Security Guide highlights audit trails as part of HIPAA compliance, which
work alongside authentication and access controls.
Reference Summary:
Salesforce Security Guide: HIPAA compliance and user authentication/access control.
Salesforce Health Cloud Admin Guide: Security and compliance features.
Salesforce Architect Resources: Security best practices for HIPAA.
Bloomington Caregivers is implementing Health Cloud to streamline the process to register patients
to care programs while capturing their consent. The company plans to leverage out-of-the-box
Health Cloud features.
Which Health Cloud feature should a consultant recommend the company use in this scenario?
B
While setting up Advanced Therapy Management, a consultant wants to have patients associated to
Care Programs during enrollment. They need to customize the Health Cloud enrollment process to
match their customer's process.
What should the consultant clone to customize for the customer, while leveraging out- of-the-box
Health Cloud functionality?
D
Explanation:
In Salesforce Health Cloud Advanced Therapy Management (ATM), the enrollment process for
associating patients to Care Programs is driven by OmniStudio OmniScripts.
Salesforce provides out-of-the-box OmniScripts for patient enrollment.
Best practice: Instead of building from scratch, you clone the delivered OmniScript and then
customize it to align with your customer’s unique enrollment process.
This approach ensures you continue to leverage Health Cloud’s standard functionality while tailoring
the process flow.
Why not the others?
A . FlexCard – Displays patient/care program info but doesn’t handle the guided enrollment process.
B . Flow – Standard Salesforce Flows are not used for ATM enrollment; Health Cloud leverages
OmniScripts for these guided workflows.
C . Apex Class – Only needed for custom logic; cloning Apex is not recommended for
configuration/customization here.
Salesforce Health Cloud Reference:
Salesforce Health Cloud Implementation Guide – Advanced Therapy Management:
“Enrollment processes for patients into Care Programs are delivered as OmniScripts. To customize
these processes, clone the standard OmniScript and modify it to meet your business needs.”