Knowledge Medical Professional CCM Points - CCM Verified Answers

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Medical Professional CCM Exam Syllabus Topics:

Section	Weight	Objectives
Ethics, Legal, and Practice Standards	18%	- Advocacy and patient rights - Legal and regulatory requirements - Professional ethics and conduct - Scope of practice and roles - Confidentiality and privacy
Quality and Outcomes Evaluation and Measurements	10%	- Data collection and reporting - Cost-benefit and effectiveness analysis - Performance improvement - Accreditation and regulatory standards - Outcome measurement and analysis
Reimbursement Methods	12%	- Payment and reimbursement methodologies - Managed care and accountable care concepts - Insurance principles and benefit structures - Coding and utilization review principles - Financial resources and negotiation
Care Management	30%	- Client-centered care plan development - Medication management - Evidence-based case management models and tools - Care coordination and collaboration - Cost containment principles - Age-specific care application - Caseload assignment and selection criteria
Healthcare Delivery Systems and Community Resources	10%	- Community-based services and resources - Healthcare policy and systems - Continuum of care settings - Interdisciplinary collaboration
Psychosocial Concepts and Support Systems	20%	- Mental health and substance use considerations - Behavioral change theories and models - Family dynamics and support systems - Abuse and neglect recognition - Cultural competence and diversity

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Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions (Q76-Q81):

NEW QUESTION # 76
You are the Contract Manager of the Engineer in a hotel project. In May 2020, the Employer and the Contractor signed a Contract based on the FIDIC Yellow Book (edition 2017), as per which the Contractor will design and build a hotel project with Contract Price of 5,100,000 USD. The Time for Completion for this project is 12 months (May 2021). The Contract also named a nominated Subcontractor (as referred to in Sub- Clause 4.5) who provides mechanical, electrical, and plumbing services for the project (including the fire fighting system), which was accepted by the Contractor without any discussions.
The Project was delayed due to issues with the fire fighting system, and you issued the Taking-Over Certificate in June 2022.
The Employer sent a Notice of Claim to the Contractor on Delay Damages with a maximum value equal to
10% of Contract Price (510,000 USD). The Employer also gave a Notice to the Contractor stating that the Contractor has failed to submit the evidence of payment to the nominated Subcontractor as well as the reason for withholding payment to the nominated Subcontractor. Therefore, the Employer has paid the nominated Subcontractor directly the entire amount due, coming to 100,000 USD. The Employer intends to include this amount as a deduction in the Final Payment to the Contractor.
As Contract Manager of the Engineer, you are tasked to make a fair determination of the Notices of the Employer. In your "Notice of the Engineer's determination", what is your determination for the deduction of the next Interim Payment to the Contractor in relation to the amount directly paid to the nominated Subcontractor?

A. The Employer is not entitled to deduct the amount directly paid.
B. The Employer is entitled to deduct the amount directly paid.

Answer: B

Explanation:
Comprehensive and Detailed Explanation:
According to FIDIC Yellow Book 2017, Sub-Clause 4.5, the Employer has the right to pay a nominated Subcontractor directly if the Contractor fails to do so and can deduct the amount from payments due to the Contractor. This provision protects nominated Subcontractors and ensures payment continuity. The Contractor's failure to provide evidence of payment and justification for withholding payment justifies the Employer's direct payment and deduction.
Thus, the Engineer's determination should allow the Employer to deduct the 100,000 USD paid directly to the nominated Subcontractor from the Contractor's next Interim Payment, ensuring fairness and contract compliance.
References:
FIDIC Yellow Book 2017 Edition, Sub-Clause 4.5 - Nominated Subcontractors FIDIC Contract Manager Study Guide, Module on Claims and Payment Procedures

NEW QUESTION # 77
(Under the FIDIC Red, Yellow, and Silver Books (both editions), the Contractor has a contractual obligation to give notice to the Employer if it discovers errors or defects of a technical nature. Is this statement true or false?)

A. True
B. False

Answer: A

Explanation:
Under all FIDIC standard forms (Red, Yellow, and Silver Books, both 1999 and 2017 editions), the Contractor has a clear contractual obligation to notify the Employer (or the Engineer, depending on the form) if it discovers errors, faults, or defects in documents or instructions of a technical nature.
This obligation is explicitly stated in Sub-Clause 1.9 [Errors in the Employer's Requirements] (particularly in Yellow and Silver Books) and similarly reflected in provisions related to documents, drawings, and instructions in the Red Book. The Contractor is required to carefully examine the documents provided and promptly give notice upon identifying any discrepancies, ambiguities, or technical defects.
The purpose of this obligation is to ensure early detection and correction of design or specification issues, thereby minimizing delays, rework, and disputes. It also reflects the principle of cooperation and proactive risk management embedded in FIDIC contracts.
Failure by the Contractor to notify such errors may result in loss of entitlement to additional time or cost if the issue later impacts execution. Therefore, this notification duty is both a technical and contractual safeguard.
Thus, the statement is true, as FIDIC imposes a clear obligation on the Contractor to notify discovered technical errors or defects.

NEW QUESTION # 78
Both FIDIC Silver Book (SB) and Yellow Book (YB) (edition 1999) mention the Contractor scrutinising the Employer's Requirements. Which statement is correct?

A. Scrutinising in FIDIC Yellow Book 1999 means the same as in FIDIC Silver Book 1999. In both models it means that after the contract closes and before starting the actual making of the design, the Contractor has to read the Employer's Requirements very thoroughly and check on any errors, omissions or conflicts.
B. Scrutinising in FIDIC Yellow Book 1999 means that the Contractor has the opportunity after contract close to report on any errors, mistakes or conflicts in the Employer's Requirements. In the FIDIC Silver Book 1999 scrutinising provides that obligation during the tender period; Contractor has the opportunity to report on any errors, mistakes or conflicts in the Employer's Requirements and for Employer to change it; for after contract closes this is not a duty anymore of Employer.
C. Scrutinising in FIDIC Silver Book 1999 means that the Contractor should read the Employer's Requirements very thoroughly after the contract closes and see if the Employer's Requirements is complete or if something is missing.
D. Scrutinising in FIDIC Yellow Book 1999 and Silver Book 1999 means that the Contractor must ask the Employer to check the Employer's Requirements very well to see if the Works can be built on that location according to the Employer's Requirements.

Answer: B

Explanation:
mprehensive and Detailed Explanation:
Option D correctly captures the difference between Yellow and Silver Books (1999):
In the Yellow Book, the Contractor may raise concerns after contract close.
In the Silver Book, the Contractor must scrutinize and report on Employer's Requirements during the tender period, and after contract close this duty lapses.
Other options misunderstand timing or scope of scrutiny.
References:
FIDIC Yellow and Silver Books 1999 Editions, Sub-Clause 4.1 - Contractor's General Obligations FIDIC Contract Manager Study Guide, Module on Employer's Requirements and Scrutiny

NEW QUESTION # 79
Which of the following cases will allow the Employer to claim under the Performance Security? [2017 Edition] (2 correct answers apply) Choose all of the correct answers (multiple possibilities).

A. The Contractor failed to extend the validity of the Performance Security.
B. The Contractor abandons the Works and the Employer did not issue Notice of termination.
C. The Contractor failed to renew the Tender Security.
D. The Engineer had issued instruction to replace part of the Works.
E. The Employer had submitted a claim under Sub-Clause 20.2.

Answer: A,C

Explanation:
Under FIDIC 2017 editions, the Performance Security protects the Employer against failure by the Contractor to fulfill contractual obligations. The Employer may claim under the Performance Security in the following cases:
Option A: Failure to renew the Tender Security as required during the tendering or contract formation phase can allow Employer to make a claim, since the security guarantees the Contractor's commitments at this stage.
Option E: Failure to extend the validity of the Performance Security when requested or required breaches contractual obligations and enables the Employer to claim under the security.
Option B is incorrect because abandonment without termination notice does not immediately entitle the Employer to claim under Performance Security; formal termination is usually required first.
Option C is incorrect because submitting a claim under Sub-Clause 20.2 (Employer's claims) does not directly correlate with claiming under Performance Security.
Option D is irrelevant; instructions to replace works do not relate to Performance Security claims.
References:
FIDIC Red, Yellow, and Silver Books 2017 Edition, Sub-Clause 4.2 - Performance Security FIDIC Contract Manager Study Guide, Module on Risk Management and Securities

NEW QUESTION # 80
(If a Section or Part has been taken-over but the Taking-Over Certificate has not been issued for the Works, the Engineer has the right to instruct a Variation to that Section/Part. Is this statement true or false?)

A. True
B. False

Answer: B

Explanation:
Under FIDIC Red and Yellow Books (both 1999 and 2017), once a Section or Part of the Works has been taken over by the Employer, even if a formal Taking-Over Certificate has not yet been issued, the practical effect is that the Works (or relevant Section) are considered completed and under the Employer's control.
Clause 13 [Variations and Adjustments] allows the Engineer to instruct Variations only before the Works or a Section are taken over. After taking-over, the Contractor's obligations shift from execution to remedying defects under Clause 11 [Defects Notification Period] . At this stage, the Contractor is no longer required to carry out new work beyond rectification unless separately agreed.
Therefore, once a Section/Part is taken over, the Engineer cannot instruct a Variation to that part of the Works. Any further work would require a separate agreement or contract, not a Variation under Clause 13.
This reflects a key FIDIC principle: Variations relate to the execution phase, not the post-completion (defects liability) phase. Thus, the statement is false.

NEW QUESTION # 81
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