CCM PrüfungGuide, Medical Professional CCM Zertifikat - Certified Case Manager Certification Exam (CCM)

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Medical Professional CCM Exam Syllabus Topics:

Section	Weight	Objectives
Quality and Outcomes Evaluation and Measurements	18%	- Quality indicator metrics and performance tools 1. Cost-benefit analysis algorithms 2. Accreditation standard configurations - Caseload calculation metrics and tracking standards
Ethical, Legal, and Practice Standards	15%	- Regulatory compliance requirements and frameworks 1. Patient privacy mandates and HIPAA 2. Affordable Care Act impacts - CCMC Code of Professional Conduct parameters
Rehabilitation Concepts and Strategies	9%	- Vocational and physical rehabilitation pathways 1. Assistive device adaptation strategies 2. Chronic illness and disability support models - Worker recovery and return-to-work solutions
Care Delivery and Reimbursement Methods	31%	- Case management concepts, processes, and principles - Reimbursement pathways and utilization management tools 1. Managed care models and funding sources 2. Government and commercial insurance plans
Psychosocial Concepts and Support Systems	27%	- Client dynamics and social determinants of health 1. Family and support system evaluation 2. Crisis intervention techniques 3. Cultural competency and spiritual influences - Behavioral health conditions and dependencies

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CCM Trainingsmaterialien: Certified Case Manager Certification Exam (CCM) & CCM Lernmittel & Medical Professional CCM Quiz

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Medical Professional Certified Case Manager Certification Exam (CCM) CCM Prüfungsfragen mit Lösungen (Q11-Q16):

11. Frage
Under the FIDIC Red Book, which one of the following statements is correct for a claim by the Contractor?

A. It is the Employer's Representative who must first respond to the claim by the Contractor.
B. The Engineer's response to the Contractor's submission of detailed particulars that are required by the procedure for claims by the Contractor must include the Engineer's final decision on the quantum.
C. The Engineer's response to a claim by the Contractor is final and binding upon the Employer.
D. The Employer has the authority to accept a claim by the Contractor, even in the case of the Contractor's failure to comply with the notice requirements.
E. If the Engineer does not make a determination, the Employer and the Contractor are unable to agree to settle an issue that gave rise to a claim.

Antwort: E

Begründung:
Under FIDIC Red Book 1999, the Engineer plays a key role in determining claims submitted by the Contractor (Clause 20). If the Engineer fails to make a determination within the prescribed time, the Parties may be unable to resolve the dispute and thus the matter may proceed to dispute resolution mechanisms.
Option B is correct because if the Engineer does not decide, the claim remains unsettled, and the Parties are left to resolve the dispute, often via Dispute Adjudication Board or arbitration.
Option A is incorrect; claims must comply with notice requirements to be valid.
Option C is incorrect because the Engineer may request further particulars but is not obligated to give a final decision on quantum immediately.
Option D is incorrect as the Engineer, not the Employer's Representative, first responds to claims.
Option E is incorrect since the Engineer's decision is not final and binding if disputed; it may be challenged.
References:
FIDIC Red Book 1999 Edition, Clause 20 - Claims, Disputes and Arbitration FIDIC Contract Manager Study Guide, Module on Claims and Dispute Resolution

12. Frage
Applying FIDIC Silver Book (edition 1999), which one of the following elements shall not form part of the time Programme/revised programme?

A. The intended order of the works.
B. Review periods under Sub-Clause 5.2.
C. The remedial work (if any) instructed under Sub-Clause 7.6.
D. The sequence and timing of inspections and tests.

Antwort: C

Begründung:
According to the FIDIC Silver Book, 1999 Edition (The Conditions of Contract for EPC/Turnkey Projects), the Contractor is required under Sub-Clause 8.3 ("Programme") to submit a time programme that illustrates the sequence and timing of the works, including milestones and key events. The intended order of the works (Option A), sequence and timing of inspections and tests (Option B), and review periods (Option D) related to contract management processes such as approval of design or submissions (Sub-Clause 5.2) are integral to effective scheduling and coordination.
However, remedial work instructed under Sub-Clause 7.6, which concerns remedying defects or damage, is generally not part of the initial or revised programme. Instead, remedial works are typically handled as separate tasks or incorporated into specific defect liability or rectification schedules after the main programme has been executed. Such remedial works arise from defects liability obligations and do not belong to the original or revised time programme used to plan the main construction phases.
This distinction is important because the programme reflects planned works execution, whereas remedial work is reactive and may be scheduled separately under defects liability clauses or final project close-out arrangements.
References:
FIDIC Silver Book 1999 Edition, Clause 8.3 - Programme
FIDIC Silver Book 1999 Edition, Clause 7.6 - Remedial Work
FIDIC Contract Manager Study Guide, Module on Time and Delay Management

13. Frage
Under the FIDIC Red and Yellow Books (edition 1999), which two of the following statements are correct regarding the issuance of Interim Payment by the Engineer?
(Choose all correct answers - multiple possibilities)

A. The Employer is bound by the Certificate issued by the Engineer, and must make payment in full, except for any compensation arising from any claim which the Employer may have against the Contractor.
B. If the Employer considers itself entitled to claim against the Contractor, notice and particulars must first be submitted under Sub-Clause 2.5. The Employer's entitlement is then to be agreed or determined by the Engineer, and then, incorporated as a deduction in a Payment Certificate.
C. The Employer is bound by the Certificate issued by the Engineer and must make payment in full, irrespective of any entitlement to compensation arising from any claim which the Employer may have against the Contractor.
D. The Employer is not bound by the Certificate issued by the Engineer.

Antwort: A,B

Begründung:
Under the FIDIC Red Book and Yellow Book, 1999 editions, the Engineer issues Interim Payment Certificates certifying the amounts due to the Contractor for completed works and materials on site (Sub- Clause 14.6). The Employer is generally bound by the Payment Certificate and must pay accordingly, except where there is a lawful set-off or compensation claim against the Contractor.
Option A is correct because the Employer must pay the amount certified except for compensation claims that may be offset against the payment (Sub-Clause 14.6).
Option D is also correct: If the Employer intends to claim against the Contractor (e.g., for damages or defects), it must notify the Contractor under Sub-Clause 2.5 and provide particulars. The Engineer then assesses and decides on the claim and incorporates any agreed deductions into the Payment Certificate.
Option B is incorrect because the Employer is indeed bound by the Payment Certificate unless lawful deductions or disputes arise.
Option C is incorrect as the Employer can withhold amounts due for compensation claims once these are properly notified and substantiated.
References:
FIDIC Red and Yellow Books, 1999 Edition, Sub-Clause 14.6 - Interim Payments FIDIC Red and Yellow Books, 1999 Edition, Sub-Clause 2.5 - Employer's Claims FIDIC Contract Manager Study Guide, Module on Payment Procedures and Financial Management

14. Frage
Which two of the following statements are correct regarding the dayworks under FIDIC Red, Yellow, and Silver Books (both editions)?
Choose all of the correct answers (multiple possibilities).

A. The dayworks related Sub-Clause is only used for remeasurement in the FIDIC Red Book (both editions) only.
B. The Engineer (or the Employer in case of FIDIC Silver Book) may instruct that " a Variation shall " be executed on a daywork basis.
C. The dayworks related Sub-Clause is also applicable to other types of works.
D. If a Daywork Schedule is not included in the Contract, the Sub-Clause related to dayworks shall not apply.

Antwort: B,C

Begründung:
Dayworks refer to works executed on a time basis (e.g., labor and plant) with payment made according to predetermined rates rather than a lump sum or unit rate contract price.
* Option A is incorrect. Even if a Daywork Schedule is not initially included, the dayworks Sub-Clause (e.
g., Sub-Clause 13.7 in Red and Yellow Books, 13.8 in Silver Book 1999) still applies to dayworks ordered during the contract execution. The schedule facilitates pricing, but the Sub-Clause governs the method and conditions for dayworks.
* Option B is correct. The dayworks Sub-Clause is applicable not only to traditional construction works but can also be applied to other types of works, such as variations or additional works that cannot be precisely measured or foreseen and are charged on a time basis.
* Option C is incorrect. The dayworks Sub-Clause is used in all FIDIC standard forms (Red, Yellow, and Silver Books), not only for remeasurement in the Red Book. In the Yellow Book (plant and design- build) and Silver Book (EPC/turnkey), dayworks are similarly applicable for certain variations or unforeseen works.
* Option D is correct. The Engineer (in Red and Yellow Books) or the Employer (in the Silver Book, where the Engineer's role is limited) may instruct that a variation be executed on a daywork basis. This instruction is typically used when the scope or quantity cannot be reasonably pre-determined.
References:
FIDIC Red Book 2017 Edition, Sub-Clause 13.7 - Dayworks
FIDIC Yellow Book 2017 Edition, Sub-Clause 13.7 - Dayworks
FIDIC Silver Book 1999 Edition, Sub-Clause 13.8 - Dayworks
FIDIC Contract Manager Study Guide, Module on Contract Administration Procedures

15. Frage
Which one of the following claim events does NOT allow profit?

A. Under the Construction Contract, interference by the Employer with Tests on Completion.
B. Under the Plant and Design-Build Contract, errors in the Employer ' s requirements.
C. Under the Construction Contract, the Engineer ' s delay in supplying drawings or issuing instructions.
D. Under the Construction Contract, the failure of the Employer to give right of access to the site.
E. Under the Construction Contract, the relevant authority had unnecessarily delayed the approval.

Antwort: E

Begründung:
Under FIDIC contracts:
Profit is usually allowed on claims arising from Employer-caused delays, instructions, or breaches that directly affect the Contractor's performance or costs (Options A, B, C, and E).
Option D relates to delays caused by third parties (authorities). Typically, delays caused by relevant authorities (e.g., permit or approval delays) are treated differently, and profit is not generally recoverable on these claims as they are considered neutral or force majeure-type delays. The Contractor may receive an extension of time and reimbursement of direct costs but not profit.
Thus, Option D is the claim event where profit is not allowed.
References:
FIDIC Red, Yellow, and Silver Books 1999 and 2017 Editions, Clauses on Claims and Compensation FIDIC Contract Manager Study Guide, Module on Claims and Profit on Claims

16. Frage
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