Health-Cloud-Accredited-Professional Exam Questions Tutorials

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.

Health Cloud supports Utilization Management (UM) through the Service Request object, which tracks prior authorization requests, and through integration with electronic prior authorization systems using MuleSoft.

Customize the Service Request object:

Extract:

“The Service Request object is at the core of the Utilization Management process in Health Cloud. You can customize fields, page layouts, and automation to match your business processes for prior authorization.”

(Source: Administer Health Cloud – Utilization Management)

Integrate using MuleSoft Direct for ePA:

Extract:

“Integrate Health Cloud Utilization Management with external systems using MuleSoft Direct, enabling electronic submission and tracking of prior authorizations.”

(Source: Administer Health Cloud – Utilization Management Integration)

Why not B or D?

There is no standard custom setting called UtilizationManagementSettings for this process.

Support Process is more for standard Salesforce Cases and not directly linked to Utilization Management flows in Health Cloud.