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| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Reimbursement Methods | 12% | - Financial resources and negotiation - Managed care and accountable care concepts - Coding and utilization review principles - Payment and reimbursement methodologies - Insurance principles and benefit structures |
| Topic 2: Ethics, Legal, and Practice Standards | 18% | - Advocacy and patient rights - Scope of practice and roles - Legal and regulatory requirements - Professional ethics and conduct - Confidentiality and privacy |
| Topic 3: Psychosocial Concepts and Support Systems | 20% | - Abuse and neglect recognition - Behavioral change theories and models - Mental health and substance use considerations - Family dynamics and support systems - Cultural competence and diversity |
| Topic 4: Healthcare Delivery Systems and Community Resources | 10% | - Community-based services and resources - Continuum of care settings - Interdisciplinary collaboration - Healthcare policy and systems |
| Topic 5: Quality and Outcomes Evaluation and Measurements | 10% | - Outcome measurement and analysis - Cost-benefit and effectiveness analysis - Accreditation and regulatory standards - Data collection and reporting - Performance improvement |
| Topic 6: Care Management | 30% | - Client-centered care plan development - Medication management - Cost containment principles - Evidence-based case management models and tools - Care coordination and collaboration - Age-specific care application - Caseload assignment and selection criteria |
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質問 # 31
(You are the Contract Manager in a contract using the FIDIC Red Book with a Dispute Avoidance and Adjudication Board. The DAAB is already appointed (standing DAAB). You are coaching your team on the steps to be followed to request for informal assistance from the DAAB during a Site visit. Which one of the following does NOT belong to those steps?)
正解：C
解説：
Under FIDIC Red Book 2017, Clause 21 (Dispute Avoidance/Adjudication Board), particularly Sub-Clause
21.3, provides for the DAAB's role in dispute avoidance, including informal assistance during site visits. This is a proactive mechanism designed to resolve issues before they escalate into formal disputes.
Key procedural requirements include: (1) both Parties must agree that they want DAAB involvement (Option A), (2) a joint written request must be submitted to the DAAB before assistance is provided (Option C), and (3) both Parties must be present during any informal discussions to ensure transparency and fairness (Option D). These steps ensure neutrality, equal participation, and procedural integrity.
Option B is incorrect and therefore the correct answer to the question. The Engineer has no formal role in authorizing or issuing a "non-objection letter" for DAAB informal assistance. The DAAB operates independently of the Engineer, and its involvement is strictly based on joint agreement between the Employer and Contractor. Introducing Engineer approval would contradict the independence and dispute avoidance function of the DAAB.
Thus, Option B does not belong to the required steps and is not supported by FIDIC provisions.
質問 # 32
(Under the FIDIC Red Book, which of the following statements are correct? [2017 Edition] (2 correct answers apply) Choose all of the correct answers (multiple possibilities).)
正解：B、C
解説：
Under the FIDIC Red Book 2017, Clause 21 establishes a standing Dispute Avoidance/Adjudication Board (DAAB) as a default requirement. This is a major evolution from the 1999 edition, where a Dispute Adjudication Board (DAB) could be ad hoc. Therefore, Option C is correct, as the General Conditions clearly provide for a standing DAAB appointed at the outset of the Contract.
Option D is also correct. The appointment procedure for DAAB members requires mutual agreement between the Parties. Even if one Party nominates a member, that nomination must be accepted by the other Party to ensure neutrality, independence, and confidence in the dispute resolution process.
Option A is incorrect because amicable settlement (Clause 21.5) is required after a DAAB decision and before arbitration, not before referring a matter to the DAAB.
Option B is incorrect because DAAB decisions are binding immediately (whether or not final), unless and until revised by arbitration. They are not dependent on prior confirmation by arbitration to be binding.
Option E is incorrect because failure to give a Notice of Dissatisfaction (NoD) relates to a DAAB decision becoming final and binding-not an Engineer's determination. The statement incorrectly mixes procedural steps.
These provisions reflect FIDIC's structured multi-tier dispute resolution system, promoting early resolution through DAAB before escalation to arbitration.
質問 # 33
Which one of the following statements is correct regarding the Provisional Sum under the FIDIC Red, Yellow, and Silver Books (edition 1999)?
正解：C
解説：
Option B is correct. Under FIDIC contracts, the Contractor must provide proof of how the Provisional Sum has been expended when requested by the Engineer. This ensures transparency and proper use of funds allocated as Provisional Sums.
Option A is incorrect; Provisional Sums are often used based on instructions from the Engineer or Employer.
Option C is incorrect because Provisional Sums are precisely intended to be used, in whole or in part, according to Engineer's or Employer's instructions.
References:
FIDIC Red, Yellow, and Silver Books 1999 Edition, Sub-Clause 13.2 - Provisional Sums FIDIC Contract Manager Study Guide, Module on Payment Procedures
質問 # 34
Under the FIDIC Silver Contract (edition 2017), which two of the answers provide for preconditions for certification and payment of the Interim Payment Certificate?
Choose all of the correct answers (multiple possibilities).
正解：A、C
解説：
Comprehensive and Detailed Explanation:
Option A is correct: Certification and payment of interim payments are conditional on Employer's receipt of the Contractor's appointment and the Advance Payment Guarantee (Sub-Clause 14.2.1).
Option D is correct: Payment also requires receipt of the Contractor's statement supported by relevant documentation.
Option B alone is insufficient without supporting documents.
Option C relates to appointment and performance security but is not a stated precondition for payment certification.
References:
FIDIC Silver Book 2017 Edition, Sub-Clause 14.6 - Interim Payment Certificates FIDIC Contract Manager Study Guide, Module on Payment Procedures
質問 # 35
(In FIDIC contracts, a number of time limits are included for the Parties and the Engineer to perform various obligations. How are failures to comply with these time limits most typically being dealt with in these forms of contracts? [2017 Edition] (1 correct answer))
正解：D
解説：
In the FIDIC 2017 suite of contracts, time bars and procedural time limits are widely used to ensure efficient contract administration and avoid delays in decision-making. However, FIDIC does not uniformly impose a strict penalty such as automatic loss of rights or damages for every missed deadline. Instead, a key contractual mechanism frequently used is the concept of a "deemed" outcome.
This means that if a Party, the Engineer, or the Employer fails to respond or act within a specified time period, the contract may prescribe an automatic consequence-often referred to as a "deemed approval," "deemed consent," or "deemed rejection." For example, under claims procedures (Clause 20), if the Engineer does not respond within the defined timeframe, certain submissions may be deemed accepted or rejected depending on the clause.
This approach ensures continuity and prevents contractual deadlock. It avoids situations where inaction by one party halts progress or creates uncertainty. It also supports the proactive management philosophy embedded in FIDIC 2017, emphasizing timely communication, strict procedural compliance, and administrative discipline.
Option A is too absolute, as loss of rights applies only in specific cases (e.g., failure to give notice of claim).
Option B is incorrect because damages are not the general remedy for missed procedural deadlines. Option D is also incorrect because outcomes are not universally made binding automatically; instead, deemed mechanisms vary depending on the clause.
Thus, the most typical approach is the use of "deemed" outcomes to maintain contractual flow.
質問 # 36
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