According to the Salesforce documentation1, the Health Cloud Provider data model is an optional data model that can be used to represent providers and their relationships in Health Cloud. It is not required for all Service Cloud to Health Cloud migrations, and it can coexist with the existing data model. The Custom Provider Search Lightning component is a custom component that can be used to search for providers using any data model, including the Health Cloud Provider data model or a custom provider data model. The Health Cloud Provider Search component is a standard component that can be used to search for providers using the Health Cloud Provider data model only. It can be extended or customized, but not replaced by a custom component1.

The admin must configure all Lead field mappings including Medical Record Number, Source System and Source System ID (A), some Lead field mappings including Medical Record Number, Source System ID can be handled automatically by HC , and duplicate checks on Medical Record Number, Source System and Source System ID can be handled automatically by HC (E) are true statements about the steps the admin can take. The custom Convert to Patient button should be added to the Lead detail page, not the list view (B). The Lead to Individual Conversion apex class will not create a new Opportunity for the patient (D).

FHIR V4 and HL7 V2 are two interoperability standards that are supported by Salesforce to facilitate the exchange of health data32. Option A is incorrect, because EDI ANSI X12 is a standard for exchanging business transactions, not health data. Option C is incorrect, because The Direct Standard is a standard for secure email communication, not health data. Option E is incorrect, because DICOM (Digital Imaging and Communications in Medicine) is a standard for storing and transmitting medical images, not health data.

According to the Health Cloud Implementation Guide, the two steps that need to be taken during the set-up process for Utilization Management are:
Install the Health Cloud Care Request Extensions unmanaged package. This package contains custom objects, fields, layouts, tabs, and components for Utilization Management.
Assign the Health Cloud Permission Set License and the Health Cloud Platform Permission Set License to Salesforce Lightning users. These licenses enable access to Health Cloud features and functionalities for Lightning Experience. Assigning the Health Cloud Permission Set License and Health Cloud Platform Permission Set License to Salesforce Classic users is not necessary for Utilization Management. Installing the Utilization Management Extensions is not a valid step for Utilization Management.

To help the payer organization electronically receive requests for services from Bloomington Caregivers, a consultant should recommend the following business level APIs:
Prior Authorization API: This API allows Bloomington Caregivers to create requests for prior authorization for services that require approval from the payer organization. The API also allows Bloomington Caregivers to update or cancel existing requests or query the status of requests9.
Care Services API: This API allows Bloomington Caregivers to create requests for care services that are covered by the payer organization's benefit plans. The API also allows Bloomington Caregivers to update or cancel existing requests or query the status of requests10.
Referral Request API: This API allows Bloomington Caregivers to create requests for referrals to other providers that are part of the payer organization's network. The API also allows Bloomington Caregivers to update or cancel existing requests or query the status of requests11. Admission, Discharge, and Transfer (ADT) API or Benefit Verification API are not business level APIs that can fulfill this requirement.