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Medical Professional CCM Exam Syllabus Topics:
| Section | Weight | Objectives |
|---|---|---|
| Topic 1: Healthcare Delivery Systems and Community Resources | 10% | - Healthcare policy and systems - Continuum of care settings - Community-based services and resources - Interdisciplinary collaboration |
| Topic 2: Reimbursement Methods | 12% | - Coding and utilization review principles - Financial resources and negotiation - Managed care and accountable care concepts - Payment and reimbursement methodologies - Insurance principles and benefit structures |
| Topic 3: Quality and Outcomes Evaluation and Measurements | 10% | - Data collection and reporting - Outcome measurement and analysis - Performance improvement - Accreditation and regulatory standards - Cost-benefit and effectiveness analysis |
| Topic 4: Ethics, Legal, and Practice Standards | 18% | - Advocacy and patient rights - Scope of practice and roles - Confidentiality and privacy - Professional ethics and conduct - Legal and regulatory requirements |
| Topic 5: Psychosocial Concepts and Support Systems | 20% | - Abuse and neglect recognition - Mental health and substance use considerations - Family dynamics and support systems - Behavioral change theories and models - Cultural competence and diversity |
| Topic 6: Care Management | 30% | - Care coordination and collaboration - Medication management - Client-centered care plan development - Caseload assignment and selection criteria - Cost containment principles - Evidence-based case management models and tools - Age-specific care application |
Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:
1. Under the FIDIC Red Book (edition 2017), the Engineer has suspended works to come to a change of the design of a part of the Works. After expiry of 84 days of suspension, the Contractor gave notice thereof.
Following this notice, the suspension was not lifted within 28 days. What two statements are correct in such a situation?
A) The Contractor may omit the affected part of Works and deny to carry out such Work going forward, but only after it has given a second notice to the Engineer.
B) Under the Contract the Parties cannot agree on further suspension and the Contractor may immediately terminate the Contract if it affects the whole Works.
C) The Contractor may terminate the Contract if it affects the whole Works, but only after it has given a second notice to the Engineer.
D) The Contractor cannot terminate the Contract.
2. In a construction project using the FIDIC Silver Book (edition 1999), if the Parties prefer the dispute board to be appointed on an " ad-hoc " basis instead of as a standing Dispute Avoidance and Adjudication Board (DAAB), what is it called? (1 correct answer applies)
A) Ad-hoc arbitration
B) DAB
C) Ad-hoc DAAB
D) Ad-hoc DB
3. Upon review of the revised programme, submitted by the Contractor, if the Engineer (under FIDIC Red or Yellow Books) or Employer (under FIDIC Silver Book) does not give a Notice of Non-Compliance within 14 days after receiving a revised programme, then ... [complete the sentence, thereby considering FIDIC Red, Yellow, and Silver Books (edition 2017)]. (1 correct answer applies)
A) The Engineer is deemed to have no objection to use the revised programme submitted by the Contractor, for the Works.
B) The Engineer shall be deemed to have given a Consent and the revised programme shall be the Programme.
C) The Contractor cannot proceed in accordance with the Programme.
D) The Contractor shall submit a Notice to the Engineer or the Employer reminding him to give its approval on the revised programme.
4. Under the FIDIC Red Book (edition 1999), as part of the Contractor submission of Statement, any amount to be deducted for retention, will be calculated by applying the percentage of retention stated in the Appendix to Tender to the total of: (two correct answers apply) Choose all of the correct answers (multiple possibilities).
A) Any amounts to be added and deducted for Plant and Materials in accordance with Sub-Clause 14.5.
B) The estimated contract value of the Works executed.
C) Any amounts to be added and/or deducted for the advance payment and repayments under Sub-Clause
14.2.
D) Any amounts to be added and deducted for changes in legislation and changes in cost.
5. The FIDIC Red Book (edition 1999) deals with Value Engineering Clause. It follows from this clause that the Contractor shall give notice to the Engineer with supporting particulars. Upon receiving this notice, the Engineer shall proceed in accordance with Sub-Clause 3.5 to agree or determine this Cost, which shall be included in the Contract Price.
A) False
B) True
Solutions:
| Question # 1 Answer: B,C | Question # 2 Answer: B | Question # 3 Answer: A | Question # 4 Answer: A,B | Question # 5 Answer: B |




