Salesforce Health-Cloud-Accredited-Professional Salesforce Health Cloud Accredited Professional AP-211 Exam Exam Practice Test

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

Request Review Types:

Utilization Management processes center around reviewing requests for appropriateness of care, with the three main types being Prior Authorization Review, Concurrent Review, and Retrospective Review.

Extract:

“Utilization Management supports prior authorization, concurrent, and retrospective reviews to evaluate care appropriateness case by case.”

— Utilization Management in Health Cloud

Care Requests:

Care Requests are the mechanism for providers to seek authorization from payers for drugs, services, or admissions.

Extract:

“Design care request processes to support providers seeking health plan authorization for services, medications, or admissions.”

— Health Cloud Utilization Management Data Model

Why not the other options?

A: Next Best Action is more for care management recommendations, not utilization review.

C: Intake agent count is an operational consideration, not a UM process.

Step-by-Step Explanation:

Business Process Capabilities:

Intelligent Document Automation: Upload and process patient insurance cards.

Intelligent Document Reader: OCR and extract information to automatically create Member Plan records.

Benefits Verification: Check and verify patient insurance benefits.

Intelligent Appointment Management: Schedule on behalf of the patient with providers.

Salesforce Documentation Reference:

“Use Intelligent Document Automation and Intelligent Document Reader to upload and extract insurance card details, with automated Member Plan creation. Use Benefits Verification and Intelligent Appointment Management to enable scheduling and eligibility checks.”— Health Cloud: Intelligent Document Automation— Health Cloud: Benefits Verification— Health Cloud: Intelligent Appointment Management

Why not the other options?

Only D includes all needed automation for insurance card processing, Member Plan record creation, benefits verification, and scheduling.

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

Experience Builder and Component Access:

Add the Provider Search component to the Experience Cloud site page for external user access.

Extract:

“Use Experience Builder to add Provider Search components to your site to enable external users to search for providers.”

— Provider Search in Experience Cloud

Read Access:

Granting Read access to the Care Provider Searchable Field object is required for site users to access search results.

Extract:

“Grant the site user profile Read access to the Care Provider Searchable Field object to allow them to view provider search results.”

— Provider Search Security

Other Options:

B: Sharing rules not typically required; object-level access is key.

D: Data Pipeline object access is not relevant for provider search results.

The Discovery Framework in Health Cloud supports:

Question Bank: Central repository of reusable questions for assessments.

Branching: Dynamic branching logic based on patient responses.

Scoring: Automatic scoring for assessments/intakes.

Extract:

“The Discovery Framework supports Question Bank, branching logic, and scoring for dynamic, reusable clinical assessments.”

(Source: Administer Health Cloud – Discovery Framework)

Encrypted Text and Image Analysis are not functions of the Discovery Framework.

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.

In Salesforce Health Cloud, when an organization needs to track account information along with geographical details (like facilities, addresses, and locations), the following objects are used:

A. Location

A standard object in Salesforce used to store physical location data such as addresses, latitude/longitude, and site details.

Useful for mapping and onsite representative visits.

B. Healthcare Facility

Represents the organization’s clinical facilities (hospitals, clinics, labs, etc.).

Connected to Accounts to model the healthcare network.

C. Facility Address

Stores detailed address information for a healthcare facility.

Provides geographical data needed by onsite reps.

Why not D. Clinic Location?

Clinic Location is not a standard Health Cloud object. The correct objects are Healthcare Facility + Facility Address + Location to track facility and geographical details.

Salesforce Health Cloud Reference:

???? Salesforce Health Cloud Provider Data Model:

“Use the Healthcare Facility object to represent hospitals, clinics, and other care sites.”

“Use the Facility Address object to store location-specific details about healthcare facilities.”

“The Location object stores standardized address and geographic information.”

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.”

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.

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 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.

In OmniStudio FlexCards, when you want to change the visual styling of a field element (e.g., font type, font color, formatting), you have two main options:

A. Write custom CSS

OmniStudio FlexCards allow applying custom CSS classes for fine-grained control of styles.

This is how you can specify a font like Times New Roman or apply a red color.

B. Make edits to Field Style

The Field Style editor within the FlexCard Designer lets you directly configure basic styling properties (like text color, background, alignment, etc.) without needing custom CSS.

Why not the others?

C. Make edits to Setup Panel – The Setup Panel is for data source, conditions, and layout configuration, not for styling individual fields.

D. Make edits to Field Properties – Field Properties are used to configure which data is displayed and how it behaves (like label, formatting rules, or conditional display), but styling is handled through Field Style or CSS, not properties.

Salesforce OmniStudio Reference:

???? Salesforce OmniStudio FlexCard Designer Guide

“You can use the Field Style editor to set basic styles, such as font color and alignment.”

“For advanced customization, apply custom CSS classes to field elements.”

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.”

Step 1: Requirement Analysis

Admin needs to leverage Advanced Therapy Management for complex gene therapy scheduling.

Step 2: Key Capabilities of Advanced Therapy Management

Book multi-step appointments: Supports sequencing and booking complex, interdependent appointments and procedures (e.g., cell collection, manufacturing, infusion).

Reschedule part of the appointment chain: Enables rescheduling one step in a multi-step process without rebooking the entire chain.

Extract:

“Advanced Therapy Management allows for the orchestration of complex, multi-step appointment chains and the flexibility to reschedule individual steps in the chain.”

Administer Health Cloud – Advanced Therapy Management

Other options:

A: Telehealth scheduling is not a specific feature of Advanced Therapy Management.

D: Einstein is not natively used for chain optimization in Advanced Therapy Management as per current documentation.

Verified Answers:

B. Book multi-step appointments.

C. Reschedule part of the appointment chain.

The Advanced Patient Card in Health Cloud is a FlexCard-based UI component that can be extended to show more patient context, such as Clinical Alerts. To display additional fields (Category, SubjectID, Date for active alerts), the developer should:

A. Clone the parent card

Best practice is to clone the delivered parent Patient Card rather than edit it directly, so you preserve the Salesforce-provided baseline functionality.

B. Create and activate a new child card

Child cards display specific contextual data (such as Clinical Alerts).

To customize which fields show, you create a new child card and activate it.

C. Create a DataRaptor to extract necessary data

Clinical Alert data must be pulled from Health Cloud objects.

A DataRaptor Extract retrieves the required fields (Category, SubjectID, Date) for use in the FlexCard child component.

Why not the others?

D. Define session variables to control visibility of clinical data – Session variables can control context in OmniStudio, but they aren’t required just to display fields on the Patient Card.

E. Change the child card state to show active – Card states are used for conditional rendering (loading, error, empty states). Showing active alerts requires data filtering in the DataRaptor, not card state changes.

Salesforce Health Cloud Reference:

???? Salesforce Health Cloud – Advanced Patient Card

“Clone the Advanced Patient Card to customize it while preserving the delivered version.”

“Use child cards to display detailed data such as conditions, medications, or clinical alerts.”

“Retrieve data for FlexCards with DataRaptor Extracts.”

 The Health Cloud Reports for Patient Referral Management unmanaged package provides prebuilt reports and dashboards to analyze referrals.

Extract:

“The Health Cloud Reports for Patient Referral Management unmanaged package includes reports and dashboards that help track patient referrals in Salesforce.”

(Source: Administer Health Cloud – Reports and Dashboards)

 Other options are either not standard package names or do not match referral reporting.

Step-by-Step Explanation:

Discovery Framework for PROMs Surveys:The Discovery Framework in Health Cloud supports question banks, standardized survey templates, and version control.

Exact Extract:

“Use the Discovery Framework to create assessments with question banks, reusable questions, and versioning to manage standardized surveys such as PROMs.”

The scenario is about sending patients’ visit information from Health Cloud to an ERP system on a weekly billing cycle.

This is a scheduled, bulk-data transfer requirement (not real-time, not request/response).

The correct integration pattern here is a batch extract using an ETL tool.

ETL tools (like Informatica, Mulesoft, Talend) are best for handling scheduled bulk data movement between Salesforce and external systems, especially for billing cycles.

The process can be scheduled nightly/weekly to pull visit data and send it to the ERP system.

Why not the others?

A. Fire and Forget with ESB – Used for real-time event-driven messaging (e.g., when an event happens, send a message immediately). Not needed here since the requirement is weekly batch.

C. ERP system to call the FHIR Billing API in Health Cloud – This would make sense if the ERP were pulling billing records via FHIR APIs, but here the need is sending visit data from Salesforce → ERP in bulk.

D. Request and Reply with ESB – Used when an external system calls Salesforce and expects an immediate response. Not applicable for scheduled, large-scale billing exports.

Salesforce Health Cloud Reference:

???? Salesforce Health Cloud Integration Guide:

“For billing, claims, or other periodic back-office processes, use a batch integration pattern with an ETL tool to extract large volumes of patient and encounter data from Salesforce on a scheduled basis.”

Salesforce Integration Patterns and Practices

Salesforce Health Cloud Data Exchange

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

Healthcare Practitioner and Healthcare Provider Objects:

Salesforce recommends using the Healthcare Practitioner object for modeling individual doctors and the Healthcare Provider object for organizations/facilities.

Extract:

“Model physicians using the Healthcare Practitioner object and relate them to organizations or facilities using the Healthcare Provider object.”

— Provider Network Management Data Model

Other Options:

A. Contact and B. Person Account are not the recommended approach for modeling licensed clinical professionals in the Health Cloud provider data model.

Step 1: Requirement Analysis

Bloomington Caregivers wants to share a patient’s medical condition details with a local hospital through integration. The recommended method must leverage Health Cloud functionality for standardized, interoperable health data sharing.

Step 2: Salesforce Health Cloud FHIR API

Health Cloud provides native support for the FHIR (Fast Healthcare Interoperability Resources) APIs to facilitate seamless and standardized clinical data exchange (including medical conditions, allergies, medications, etc.) with external systems.

Extract:

“Health Cloud supports the FHIR standard and provides FHIR APIs for accessing and sharing clinical data such as conditions, observations, and encounters with external health systems.”

Administer Health Cloud – FHIR APIs

Step 3: Review of Options

A. Expose the MedicalCondition object through an Apex class: Not standards-based; not recommended for clinical interoperability.

B. Use the FHIR Patient API through DataRaptor: DataRaptor is an OmniStudio tool for extracting data, but not specifically for FHIR API access.

C. Leverage the MedicalCondition Integration Procedure: Integration Procedures are used for orchestrating APIs but are not directly the mechanism for sharing FHIR data externally.

D. integrate using the FHIR Clinical API: Correct – aligns with healthcare interoperability standards and Health Cloud's FHIR support.

Out-of-the-box caller authentication in Health Cloud is primarily supported through Identity Verification Flow Templates. These flow templates are designed to help organizations comply with HIPAA and other regulatory requirements by standardizing the caller verification process for contact center agents.

Step-by-Step Reference:

Health Cloud provides Identity Verification Flow Templates that streamline the authentication of callers, reducing manual processes and ensuring regulatory compliance.

Extract:

“Use the Health Cloud Identity Verification Flow Templates to verify a caller’s identity based on information you select, such as date of birth, phone number, or other criteria.”

(Source: Administer Health Cloud)

These templates can be deployed as standard flows and easily customized for the organization's authentication requirements.

Extract:

“Leverage out-of-the-box Identity Verification Flow Templates to quickly set up and deploy identity verification processes in your contact center.”

(Source: Administer Health Cloud - Identity Verification)

This approach is preferred over FlexCards, OmniScripts, or ad-hoc processes, as it provides a compliant and guided experience.

When configuring security, sharing, and visibility in Salesforce Health Cloud, consultants must consider healthcare-specific requirements such as HIPAA, GDPR, and organizational policies. Two critical considerations are:

B. Understand customer needs, data security, privacy concerns, regulatory compliance, and sharing or visibility restrictions.

Healthcare data involves PHI (Protected Health Information), which requires strict compliance with HIPAA and regional regulations.

Consultants must tailor security models to meet specific privacy and compliance requirements.

C. Regularly review and update security, sharing, and visibility settings in Health Cloud to align with evolving needs, regulations, and organizational policies.

Regulations change, and so do organizational needs. Security and sharing rules must be reviewed and updated periodically to ensure ongoing compliance and relevance.

Why not the others?

A. Ensure that data mask is used in production to appropriately manage PHI.

Salesforce Data Mask is a tool for sandbox data anonymization, not for production. PHI in production should be secured using encryption, field-level security, and sharing rules—not Data Mask.

D. Review Salesforce documentation and implement a standardized security and visibility model.

While documentation is helpful, healthcare organizations require tailored security models that fit unique compliance and data access needs, not a one-size-fits-all model.

Salesforce Health Cloud Reference:

???? Salesforce Health Cloud Security & Compliance Guidance:

“When configuring Health Cloud, ensure security models reflect customer needs, privacy concerns, and regulatory compliance (HIPAA, GDPR, etc.).”

“Review and update security, sharing, and visibility models regularly to address evolving business, regulatory, and compliance requirements.”