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Medical Professional CCM Exam Syllabus Topics:

SectionWeightObjectives
Topic 1: Care Delivery and Reimbursement Methods31%- Reimbursement pathways and utilization management tools
  • 1. Government and commercial insurance plans
  • 2. Managed care models and funding sources
- Case management concepts, processes, and principles
Topic 2: Psychosocial Concepts and Support Systems27%- Behavioral health conditions and dependencies
- Client dynamics and social determinants of health
  • 1. Crisis intervention techniques
  • 2. Family and support system evaluation
  • 3. Cultural competency and spiritual influences
Topic 3: Quality and Outcomes Evaluation and Measurements18%- Caseload calculation metrics and tracking standards
- Quality indicator metrics and performance tools
  • 1. Accreditation standard configurations
  • 2. Cost-benefit analysis algorithms
Topic 4: Rehabilitation Concepts and Strategies9%- Worker recovery and return-to-work solutions
- Vocational and physical rehabilitation pathways
  • 1. Chronic illness and disability support models
  • 2. Assistive device adaptation strategies
Topic 5: Ethical, Legal, and Practice Standards15%- Regulatory compliance requirements and frameworks
  • 1. Patient privacy mandates and HIPAA
  • 2. Affordable Care Act impacts
- CCMC Code of Professional Conduct parameters

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Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions (Q97-Q102):

NEW QUESTION # 97
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: D

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 # 98
(Under the FIDIC Yellow Book (edition 1999), any delay caused by Authorities will be considered as a cause of Delay under sub paragraph (b) of Sub-Clause 8.5 under the only condition that the Contractor has diligently followed the procedures laid down by the public authorities in the Country. Is this statement true or false?)

Answer: A

Explanation:
Under FIDIC Yellow Book 1999, Sub-Clause 8.5 [Delays Caused by Authorities] addresses situations where delays arise due to actions or inactions of public authorities. Sub-paragraph (b) specifically provides that delays caused by authorities may entitle the Contractor to an extension of time, provided certain conditions are satisfied.
A critical condition clearly stated in this clause is that the Contractor must have "diligently followed the procedures laid down by the relevant legally constituted public authorities in the Country." This requirement reflects an important FIDIC contract management principle: entitlement to relief is conditional upon proper Contractor performance. If the Contractor fails to comply with statutory procedures, permit processes, or administrative requirements, then delays cannot be attributed to the authorities for the purpose of claiming time extension.
From a practical perspective, this clause ensures a balanced allocation of risk. While the Employer bears the risk of delays caused by external authorities, the Contractor retains responsibility for proper compliance with all legal and procedural obligations. The Engineer will typically assess whether the Contractor acted diligently before granting any extension of time under Clause 8.4 in conjunction with Sub-Clause 8.5.
Therefore, the statement is correct, as diligence in following authority procedures is a prerequisite for claiming delay under this provision.


NEW QUESTION # 99
(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?)

Answer: D

Explanation:
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.


NEW QUESTION # 100
Regarding FIDIC Yellow and Silver Books (edition 1999) the Contractor has submitted its design proposal through the Contractor's Proposal. Which two of the following statements are true in this respect, after it has been submitted?
Choose all of the correct answers (multiple possibilities).

Answer: C,D

Explanation:
Option B is correct: The Contractor must obtain approval from the Engineer/Employer before making design changes.
Option C is correct: The Contractor can submit Value Engineering proposals to improve efficiency or reduce costs.
Option A is incorrect; unilateral changes are not allowed.
Option D is incorrect; Value Engineering can be proposed even after initial submission.
References:
FIDIC Yellow and Silver Books 1999 Edition, Sub-Clauses 4.1 and 4.4
FIDIC Contract Manager Study Guide, Module on Design and Value Engineering


NEW QUESTION # 101
Which one of the following statements is correct regarding the Provisional Sum under the FIDIC Red, Yellow, and Silver Books (edition 1999)?

Answer: B

Explanation:
Comprehensive and Detailed Explanation:
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


NEW QUESTION # 102
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