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Medical Professional CCM Exam Syllabus Topics:
| Section | Weight | Objectives |
| Topic 1: Reimbursement Methods | 12% | - Financial resources and negotiation
- Managed care and accountable care concepts
- Payment and reimbursement methodologies
- Coding and utilization review principles
- Insurance principles and benefit structures
|
| Topic 2: Psychosocial Concepts and Support Systems | 20% | - Family dynamics and support systems
- Mental health and substance use considerations
- Abuse and neglect recognition
- Cultural competence and diversity
- Behavioral change theories and models
|
| Topic 3: Healthcare Delivery Systems and Community Resources | 10% | - Community-based services and resources
- Healthcare policy and systems
- Continuum of care settings
- Interdisciplinary collaboration
|
| Topic 4: Care Management | 30% | - Age-specific care application
- Client-centered care plan development
- Cost containment principles
- Evidence-based case management models and tools
- Caseload assignment and selection criteria
- Medication management
- Care coordination and collaboration
|
| Topic 5: Ethics, Legal, and Practice Standards | 18% | - Professional ethics and conduct
- Legal and regulatory requirements
- Advocacy and patient rights
- Confidentiality and privacy
- Scope of practice and roles
|
| Topic 6: Quality and Outcomes Evaluation and Measurements | 10% | - Cost-benefit and effectiveness analysis
- Accreditation and regulatory standards
- Data collection and reporting
- Performance improvement
- Outcome measurement and analysis
|
Medical Professional Certified Case Manager Certification Exam (CCM) Sample Questions:
1. Which one of the following statements is correct regarding the Provisional Sum under the FIDIC Red, Yellow, and Silver Books (edition 1999)?
A) Each Provisional Sum shall not be used, in whole or in part, in accordance with instructions from the Engineer.
B) The Contractor shall, when required by the Engineer, produce proof to substantiate how it has used the Provisional Sum.
C) The Provisional Sum cannot be issued by instruction either by the Engineer (or Employer in case of FIDIC Silver Book).
2. Under the FIDIC Red Book (edition 1999), if the Contractor as per Sub-Clause 14.2 has to ensure the Employer receives an Advance Payment Guarantee as per the standard model, what type of instrument should this be?
A) A bank guarantee
B) A declaration of joint and several liability
C) A surety bond
D) A parent company guarantee
3. 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).
A) FIDIC Conditions of Contract for Plant and Design Build ( " Yellow Book " ).
B) FIDIC Conditions of Contract for EPC/Turnkey Projects ( " Silver Book " ).
C) FIDIC Conditions of Contract for Construction ( " Red Book " ).
4. You are the Contract Manager in a highway project using FIDIC Red Book (edition 1999). You work for the Employer - a highway management agency. During the tender period, you are informed of a specific Commencement Date required by the directors of the agency. Which two of the following approaches to inform the tenderers of this date are clearly and unambiguously drafted?
Choose all of the correct answers (multiple possibilities).
A) Specify Commencement Date in the Minutes of Meeting of Contract Negotiation.
B) Inform the Commencement Date to the tenderers by email, and attach that email in the list of Contract Documents.
C) Specify Commencement Date in the Particular Conditions.
D) Specify Commencement Date in the Contract Agreement.
5. 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) The Contractor may terminate the Contract if it affects the whole Works, but only after it has given a second notice to the Engineer.
C) Under the Contract the Parties cannot agree on further suspension and the Contractor may immediately terminate the Contract if it affects the whole Works.
D) The Contractor cannot terminate the Contract.
Solutions:
Question # 1 Answer: B | Question # 2 Answer: A | Question # 3 Answer: A,C | Question # 4 Answer: C,D | Question # 5 Answer: B,C |