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Medical Professional CCM Exam Syllabus Topics:

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

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Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions (Q25-Q30):

NEW QUESTION # 25
Which one of the following claim events does NOT allow profit?

Answer: E

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 # 26
(Which two answers show characteristics of Test on Completion or Test After Completion under the FIDIC Silver Book (edition 1999)?
Choose all of the correct answers (multiple possibilities).)

Answer: A,B

Explanation:
Under the FIDIC Silver Book 1999, Clause 9 governs Tests on Completion, while Clause 12.4 addresses Tests after Completion. These provisions define performance verification before and after Taking-Over.
Option A is correct. Under Sub-Clause 9.4 [Failure to Pass Tests on Completion], if the Works fail the Tests on Completion, the Employer has several options, including accepting the Works subject to a reduction in the Contract Price. This reflects the commercial flexibility within FIDIC, allowing completion despite minor deficiencies, with financial adjustment.
Option D is also correct. Under Sub-Clause 12.4 [Failure to Pass Tests after Completion], if the Works fail post-completion performance tests, the Contractor may be required to pay performance damages. Once these damages are paid, the Works may be deemed to have satisfied the required performance levels. This mechanism ensures that operational deficiencies are compensated financially rather than requiring physical rectification in all cases.
Option B is incorrect because both Tests on Completion and Tests after Completion can coexist within the same contract; they serve different purposes (pre-taking-over vs post-taking-over performance verification).
Option C is incorrect because Tests after Completion are generally carried out by or under the responsibility of the Contractor, not solely the Employer, although the Employer may witness them.
These provisions demonstrate FIDIC's structured approach to quality assurance and risk allocation across different project stages.


NEW QUESTION # 27
Which of the following documents form part of a FIDIC Construction Contract ["Red Book" (1999)], hence, to be drafted and included among the Tender Documents? (2 correct answers apply) Choose all of the correct answers (multiple possibilities).

Answer: B,D

Explanation:
Under the FIDIC Red Book (1999), the Tender Documents typically include:
The Bill of Quantities (Option B), which provides detailed quantities for priced items and forms a basis for tender pricing.
The Specifications (Option E), which define the technical requirements for the Works.
The Schedule of Guarantees (Option A) is usually provided later, during contract formation, not as part of tender documents.
Employer's Requirements (Option C) are more commonly referenced in design-build contracts such as the Yellow Book, not the Red Book which is traditionally a design-bid-build contract.
Schedule of Baselines (Option D) is not a standard tender document in FIDIC Red Book contracts.
References:
FIDIC Red Book 1999 Edition - Tender Documents Section
FIDIC Contract Manager Study Guide, Module on Tendering Documents


NEW QUESTION # 28
Which of the following FIDIC contract forms require certification in the payment process? (2 correct answers apply) Choose all of the correct answers (multiple possibilities).

Answer: A,C

Explanation:
Options A and B are correct: Both the Red and Yellow Books require the Engineer to certify payments before the Employer pays the Contractor.
Option C (Silver Book) typically places the risk on the Contractor and often provides for payment without Engineer certification, reflecting the turnkey nature of the contract.
References:
FIDIC Red and Yellow Books 1999 & 2017 Editions, Clauses on Payment Certification FIDIC Silver Book 1999 & 2017 Editions - Payment Provisions FIDIC Contract Manager Study Guide, Module on Payment Procedures


NEW QUESTION # 29
(Under FIDIC Red and Yellow Books (both editions) the Engineer must have received technical education. Is this statement true or false?)

Answer: B

Explanation:
Under both FIDIC Red and Yellow Books (1999 and 2017 editions), the Engineer is defined as the person appointed by the Employer to carry out duties assigned under the Contract (Clause 3). However, FIDIC does not prescribe any specific qualification, such as requiring the Engineer to have a formal technical education.
The contract focuses on the role and functions of the Engineer rather than formal credentials. The Engineer is expected to act as a professional administrator of the contract, performing duties such as issuing instructions, certifying payments, making determinations, and acting neutrally when required (especially under FIDIC
2017, Clause 3.7). While in practice Engineers are typically qualified professionals (often engineers by training), this is a matter of industry practice, not a contractual requirement.
FIDIC intentionally avoids prescribing qualifications to allow flexibility for the Employer in appointing a suitable representative with the necessary competence and experience for the specific project. The emphasis is on capability and impartiality, rather than formal academic credentials.
Therefore, the statement is false because FIDIC contracts do not mandate that the Engineer must have received technical education


NEW QUESTION # 30
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