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Medical Professional CCM Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Quality and Outcomes Evaluation and Measurements | 10% | - Outcome measurement and analysis - Performance improvement - Cost-benefit and effectiveness analysis - Accreditation and regulatory standards - Data collection and reporting |
| Topic 2: Psychosocial Concepts and Support Systems | 20% | - Behavioral change theories and models - Cultural competence and diversity - Abuse and neglect recognition - Mental health and substance use considerations - Family dynamics and support systems |
| Topic 3: Healthcare Delivery Systems and Community Resources | 10% | - Interdisciplinary collaboration - Community-based services and resources - Healthcare policy and systems - Continuum of care settings |
| Topic 4: Ethics, Legal, and Practice Standards | 18% | - Legal and regulatory requirements - Confidentiality and privacy - Advocacy and patient rights - Professional ethics and conduct - Scope of practice and roles |
| Topic 5: Care Management | 30% | - Cost containment principles - Client-centered care plan development - Care coordination and collaboration - Caseload assignment and selection criteria - Medication management - Age-specific care application - Evidence-based case management models and tools |
| Topic 6: Reimbursement Methods | 12% | - Payment and reimbursement methodologies - Coding and utilization review principles - Financial resources and negotiation - Managed care and accountable care concepts - Insurance principles and benefit structures |
Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:
1. Which two statements are correct regarding the FIDIC Red Book (edition 2017)?
A) Contract Data contains information which is required by certain Sub-Clauses in the General Conditions.
B) There is never a difference in effect whether in the Particular Conditions when the term " Works " is used, or when the term " works " is used.
C) In some cases, if a certain information is not provided in the Contract Data, the relevant Sub-Clause shall not be applicable.
D) Words and expressions stated in Sub-Clause 1.1 Definitions do not apply in respect of Specifications and Drawings.
2. (Which two of the following statements are correct regarding types of Claims under the FIDIC Red, Yellow, and Silver Books (edition 2017)?
Choose all of the correct answers (multiple possibilities).)
A) The limit in time referred to in Sub-Clause 20.2.1 (also known as time bar) applies to all types of Claims.
B) The time bar only applies to Contractor's Claims and not to Employer's Claims.
C) If a Claim is submitted as per sub-paragraph (c) of Sub-Clause 20.1, this is dealt with by the Engineer or Employer's Representative (in case of FIDIC Silver Book) as per Sub-Clause 3.7/3.5.
D) If a Claim is submitted as per sub-paragraphs (a) or (b) of Sub-Clause 20.1, it is dealt with in accordance with Sub-Clause 20.2, which specifically covers claims for time and/or money. Part of the procedure under Sub-Clause 20.2 is for a payment and/or an extension of time-related claim to be agreed or determined by the Engineer/Employer's Representative (in case of the FIDIC Silver Book) in accordance with Sub-Clause 3.7/3.5.
3. (You are the Contract Manager for the Engineer in a highway project using FIDIC Red Book (edition 1999).
There is a Schedule of cost indexation included in the Contract. The project must be completed by 31 December of this year. If the Contractor fails to complete the Works by then, how will the adjustment of prices take place thereafter? (1 correct answer applies))
A) Each index or price applicable on the date 49 days before the expiry of the Time for Completion of the Works.
B) The current index or price.
C) Either the current index/price, or index or price applicable on the date 49 days before the expiry of the Time for Completion of the Works, whichever is agreed by the Parties.
D) Either the current index/price, or index or price applicable on the date 49 days before the expiry of the Time for Completion of the Works, whichever is more favourable to the Employer.
4. Which one of the following statements is NOT correct in respect of FIDIC Yellow Book (both editions)?
A) The Contract typically becomes legally effective when the Employer issues the Letter of Acceptance to the Contractor.
B) The Contractor provides plant and designs (except as otherwise specified) and executes the other works, all in accordance with the Contract, which includes its Proposal and the Employer ' s Requirements.
C) A disproportionate amount of risks is allocated to the Contractor under the General Conditions.
D) The General Conditions allocate the risks between the parties on a fair and equitable basis.
5. The FIDIC Red Book (edition 1999) deals with Value Engineering Clause. It follows from this clause that the Contractor shall give notice to the Engineer with supporting particulars. Upon receiving this notice, the Engineer shall proceed in accordance with Sub-Clause 3.5 to agree or determine this Cost, which shall be included in the Contract Price.
A) True
B) False
Solutions:
| Question # 1 Answer: A,C | Question # 2 Answer: A,D | Question # 3 Answer: D | Question # 4 Answer: C | Question # 5 Answer: A |
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