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Medical Professional CCM Exam Syllabus Topics:

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

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Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions (Q56-Q61):

NEW QUESTION # 56
The Employer has prepared a contract for a waste-to-energy project based on the FIDIC Yellow Book (edition
1999). You are preparing negotiations on behalf of one of the Subcontractors with the Contractor. The main Contractor will manage the design and build of the Works, whereby the Subcontractor will deliver critical systems regarding power generation and cooling. The Contractor intends to contract the main Contract back- to-back with the Subcontractor. In the proposed back-to-back subcontract, the following amendment is proposed through Particular Conditions:
"Sub-Clause 4.4. The following paragraph is added: The Subcontractor is required to scrutinize the Employer's Requirements in a manner identical to the obligations of the Contractor as stated in Sub-Clause
5.1 of the Main Contract. The Subcontractor will indemnify and hold harmless (up to the maximum liability of the Subcontractor) the Contractor with regard to any error, fault or other defect found in the Employer's Requirements, its items of reference or Contractor's design of the Works for the scope part for which Subcontractor is contracted." What is your advice to the Subcontractor (SC) in regard to entering this proposed subcontract?

Answer: A

Explanation:
In FIDIC Yellow Book (1999), the Contractor is responsible for scrutinizing the Employer's Requirements per Sub-Clause 5.1 and must notify any discrepancies or errors. However, passing this obligation to a Subcontractor, and requiring the Subcontractor to indemnify the Contractor for errors or defects arising from the Employer's Requirements or the Contractor's design, unfairly shifts risk and liability to the Subcontractor.
The Subcontractor is likely not in a position to fully review or control the Employer's Requirements or the overall Contractor's design. This exposes the Subcontractor to excessive risk, beyond their scope and capacity.
Advice C highlights that the Subcontractor becomes vulnerable to claims for design defects outside their control. This misallocation of risk is generally not recommended and can be challenged during contract negotiation. Good contract management practice and risk allocation principles (FIDIC Contract Manager Study Guide, Module on Claims and Dispute Resolution) support this position.
While Options A, B, and D propose different approaches, only C correctly identifies the fundamental contractual and risk management issue that should prevent the Subcontractor from entering the contract as is.
References:
FIDIC Yellow Book 1999, Sub-Clause 5.1 - Contractor's General Obligations FIDIC Contract Manager Study Guide, Module on Claims and Dispute Resolution FIDIC Contract Manager Study Guide, Module on Risk Management


NEW QUESTION # 57
(Under the FIDIC Red and Yellow Books (edition 1999), which two of the following answers are correct regarding the application for Interim Payment Certificates? Choose all correct answers.)

Answer: A,D

Explanation:
Under FIDIC Red Book and Yellow Book 1999, Sub-Clause 14.3 [Application for Interim Payment Certificates] governs the Contractor's obligations when submitting statements for interim payments.
Option B is correct because the Statement must include amounts relating to Provisional Sums where applicable. These sums form part of the Contract Price adjustments and must be reflected in interim applications when instructed or executed.
Option C is also correct. Sub-Clause 14.3 explicitly requires that each Statement be accompanied by supporting documents. This includes records of progress and, importantly, the progress report under Sub- Clause 4.21 [Progress Reports], ensuring that the Engineer can properly assess the value of work done.
Option A is incorrect because FIDIC does not mandate submission "in five copies" nor submission directly to the Employer; typically, submissions are made to the Engineer, and the number of copies is not fixed in the General Conditions.
Option D is incorrect as stated. While Plant and Materials may be considered under Sub-Clause 14.5 [Plant and Materials intended for the Works], their inclusion is subject to specific conditions and certification, not simply "added and deducted" generically within every Statement.
Thus, the correct application aligns with procedural compliance, proper substantiation, and inclusion of relevant financial components as per Clause 14.


NEW QUESTION # 58
For the FIDIC Red Book (both editions), the Contractor is required to submit a progress report monthly.
When does the Contractor's reporting requirement end?

Answer: B

Explanation:
The Contractor's obligation to submit progress reports continues until all outstanding work identified in the Taking-Over Certificate has been completed. The Taking-Over Certificate signals substantial completion but may allow for outstanding minor works. Reporting is essential to monitor progress on these outstanding works.
The Performance Certificate relates to final contract completion but reporting usually ends earlier only after all works are completed.
Therefore, Option D is correct.
References:
FIDIC Red Book 1999 & 2017 Editions, Sub-Clause 4.21 - Progress Reports FIDIC Contract Manager Study Guide, Module on Communication and Reporting


NEW QUESTION # 59
Which FIDIC Book (edition 2017) should be considered first by an Employer that is an experienced employer who knows exactly what they want from a design & engineering perspective?

Answer: D

Explanation:
The FIDIC Red Book (2017 edition) is traditionally used for construction contracts where the Employer provides the design, and the Contractor primarily executes the construction works. This form is suitable for Employers who have detailed and well-defined design and engineering requirements and want to retain control over the design.
* TheRed Bookis ideal for experienced Employers who have a clear and fixed design and require the Contractor to build accordingly.
* TheYellow Bookis typically used where the Contractor is responsible for both design and construction (design & build). It suits Employers who want to delegate design responsibility to the Contractor.
* TheSilver Bookis used for turnkey or EPC contracts where the Contractor takes full responsibility for design, procurement, construction, and commissioning, suitable for Employers seeking minimal involvement in design and execution details.
* Hence, for an Employer whoknows exactly what they wantfrom a design and engineering perspective and wants to maintain control, theRed Bookis the first and most appropriate choice.
References:
FIDIC Red Book 2017 Edition - Conditions of Contract for Construction
FIDIC Yellow Book 2017 Edition - Conditions of Contract for Plant and Design-Build FIDIC Silver Book 2017 Edition - Conditions of Contract for EPC/Turnkey Projects FIDIC Contract Manager Study Guide, Module on Contract Selection


NEW QUESTION # 60
Which one of the following statements is NOT correct in respect of FIDIC Yellow Book (both editions)?

Answer: D

Explanation:
Option C is NOT correct. FIDIC Yellow Book General Conditions aim to allocate risks fairly and equitably between the Employer and Contractor. The contract balances risks according to who is best able to manage them. It does not impose a disproportionate risk burden on the Contractor.
Options A, B, and D are correct statements describing typical contract formation, risk allocation, and Contractor's design and execution responsibilities.
References:
FIDIC Yellow Book 1999 and 2017 Editions - Introduction and Risk Allocation Clauses FIDIC Contract Manager Study Guide, Module on Introduction to FIDIC Contracts


NEW QUESTION # 61
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