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Medical Professional CCM Exam Syllabus Topics:

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

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Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions (Q111-Q116):

NEW QUESTION # 111
When is the Employer obliged to return the Performance Security (PS) under the FIDIC Red Book (edition
1999)?

A. Within 21 days after the issuance of the Taking-Over Certificate.
B. Within 21 days after the issuance of the Performance Certificate.
C. Without undue delay after the issuance of the Performance Certificate.
D. Without undue delay after the issuance of the Taking-Over Certificate.

Answer: B

Explanation:
Comprehensive and Detailed Explanation:
Under FIDIC Red Book 1999, the Performance Security (or Performance Guarantee) is held to ensure the Contractor's performance during the defects liability period. The security is typically released only after the Employer issues the Performance Certificate, which confirms the completion of defects liability obligations and that the Contractor has fulfilled the contract.
The contract commonly specifies a fixed period (often 21 days) within which the Employer must return the Performance Security after issuance of the Performance Certificate (Option D). The Taking-Over Certificate (Options A and C) marks substantial completion but does not end the Contractor's obligations for defects.
References:
FIDIC Red Book 1999, Sub-Clause 10.2 - Taking-Over Certificate
FIDIC Red Book 1999, Sub-Clause 10.4 - Performance Certificate
FIDIC Red Book 1999, Sub-Clause 10.5 - Release of Performance Security
FIDIC Contract Manager Study Guide, Module on Payment Procedures and Financial Management

NEW QUESTION # 112
Under the FIDIC Red Book, which one of the following statements is correct for a claim by the Contractor?

A. 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.
B. The Engineer's response to a claim by the Contractor is final and binding upon the Employer.
C. 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.
D. It is the Employer's Representative who must first respond to the claim by the Contractor.
E. 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.

Answer: A

Explanation:
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

NEW QUESTION # 113
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 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.
B. 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.
C. 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.
D. 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.

Answer: A

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 # 114
Which one of the following documents constitutes a contract and is considered binding on both parties, when the Employer wants to award the Contract to the tenderer?

A. Memorandum of understanding
B. Letter of Intent & Memorandum of understanding
C. Letter of Intent
D. Letter of Acceptance

Answer: D

NEW QUESTION # 115
Which one of the following claim events does NOT allow profit?

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

Answer: A

Explanation:
Comprehensive and Detailed Explanation:
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

NEW QUESTION # 116
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