Salesforce Health Cloud Health-Cloud-Accredited-Professional Question # 10 Topic 2 Discussion

To automate the capture of data from faxes for clinical reviews and manage the approval process in Salesforce Health Cloud, the following capabilities are recommended:

Utilization Management in Health Cloud supports the payer's clinical review process by enabling workflows for reviewing medical necessity and care appropriateness.

It provides structured workflows for processing clinical documents, making it ideal for end-to-end determination and approval processes.

Features include care authorizations, review tracking, and decision management.

Intelligent Document Automation extracts data from documents (e.g., faxes, PDFs) and populates corresponding Salesforce records.

This capability reduces manual data entry, improves accuracy, and ensures data is automatically captured from the faxes received.

Paired with Salesforce workflows, it can trigger approvals or further reviews based on extracted data.

1. Utilization Management (A):2. Intelligent Document Automation (C):Why Other Options Are Incorrect:

B. Integrated Care Management: Focuses on patient care plans and coordination, not clinical review or payer processes.

D. Care Authorizations: Handles care approvals but does not support document data extraction or end-to-end review processes.

References:

Utilization Management in Health Cloud

Intelligent Document Automation Overview