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Medical Professional CCM Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Reimbursement Methods12%- Insurance principles and benefit structures
- Coding and utilization review principles
- Managed care and accountable care concepts
- Financial resources and negotiation
- Payment and reimbursement methodologies
Topic 2: Healthcare Delivery Systems and Community Resources10%- Healthcare policy and systems
- Community-based services and resources
- Interdisciplinary collaboration
- Continuum of care settings
Topic 3: Ethics, Legal, and Practice Standards18%- Advocacy and patient rights
- Confidentiality and privacy
- Legal and regulatory requirements
- Professional ethics and conduct
- Scope of practice and roles
Topic 4: Quality and Outcomes Evaluation and Measurements10%- Data collection and reporting
- Performance improvement
- Cost-benefit and effectiveness analysis
- Accreditation and regulatory standards
- Outcome measurement and analysis
Topic 5: Care Management30%- Evidence-based case management models and tools
- Caseload assignment and selection criteria
- Age-specific care application
- Medication management
- Client-centered care plan development
- Cost containment principles
- Care coordination and collaboration
Topic 6: Psychosocial Concepts and Support Systems20%- Cultural competence and diversity
- Family dynamics and support systems
- Mental health and substance use considerations
- Behavioral change theories and models
- Abuse and neglect recognition

Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:

1. Under the FIDIC Red, Yellow, and Silver Books (edition 2017), if a Dispute is referred to the Dispute Avoidance and Adjudication Board (DAAB) to obtain its decision, the Parties shall suspend performing their obligations in accordance with the Contract, until they receive further directions from the DAAB. Is this statement true or false?

A) True
B) False


2. (In a region experiencing civil unrest and armed conflict under a FIDIC Red Book 1999 Contract, violence escalates into an insurrection, forcing the Contractor to stop work and retreat to a secured compound. The Contractor issues a notice claiming this is an Employer's Risk under Sub-Clause 17.3 (a) and (b), requesting Extension of Time and Cost. What is the most appropriate position for the Engineer at this stage?)

A) The Contractor should have foreseen such risks due to the region's history; therefore, Clause 19 is not applicable.
B) The Employer is in breach of its obligation to provide safe working conditions under Sub-Clause 2.1; therefore, the Contractor can claim on that basis.
C) This is an Employer's Risk under Sub-Clause 17.3 (a)/(b), and the Contractor is entitled to EOT and Cost. The Engineer will assess actual entitlement after the event; no further notices are required.
D) Violence is an Employer's Risk; however, the Contractor can only claim after the situation ends. The Engineer cannot determine EOT or Cost yet, and the Contractor must submit a fully detailed claim later.


3. Which two statements reflect an INCORRECT application of a Golden Principle?

A) The Contractor ' s right to suspend work (or reduce the rate of work) effective after giving not less than
3 months (in lieu of 21 days) notice to the Employer.
B) Any deletions of General Conditions (GC) must be replaced with Particular Conditions (PC) that cover the same scope, and do not leave any roles, duties, obligations, rights, and risk allocation undefined.
C) Deleting all the clauses in the General Conditions that refer to the DAAB/DAB.
D) When applying the FIDIC Red Book or Yellow Book, the Commencement Date shall be within 60 days after the Contractor receives the Letter of Acceptance, in lieu of 42 days.


4. (Which of the following two statements are correct regarding subcontractors under FIDIC Red, Yellow, and Silver Books (edition 2017)?
Choose all of the correct answers (multiple possibilities).)

A) If no maximum allowable accumulated value of work subcontracted is stated in the Contract Data, the Contractor shall not be entitled to subcontract the whole of the Works without prior consent of the Engineer.
B) The Contract Data may identify parts of the Works which the Contractor is not entitled to subcontract.
C) The Contractor shall obtain the Engineer's and the Employer's prior consent to all Subcontractors.
D) The Contractor shall not be responsible for the acts or defaults of any Subcontractor.


5. When is the Employer obliged to return the Performance Security (PS) under the FIDIC Red Book (edition
1999)?

A) Without undue delay after the issuance of the Performance Certificate.
B) Without undue delay after the issuance of the Taking-Over Certificate.
C) Within 21 days after the issuance of the Performance Certificate.
D) Within 21 days after the issuance of the Taking-Over Certificate.


Solutions:

Question # 1
Answer: B
Question # 2
Answer: C
Question # 3
Answer: C,D
Question # 4
Answer: A,B
Question # 5
Answer: C

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