CCM Multiple Choice Questions with
Complete Solutions (Latest 2025)
All of the following are true regarding coordination of benefits
(COB) except:
A) COB prevents double payment for services when a
subscriber has health insurance coverage from two or more
sources.
B) COB is voluntary.
C) COB determines which insurer pays first when the insured
is covered under more than one health insurance policy.
D) COB coordinates workers' compensation with health
insurance coverage. - Correct Answers ✅Answer: D) COB
coordinates workers' compensation with health insurance
coverage.
Rationale: COB does not coordinate benefits with workers
compensation. COB is a voluntary program that prevents
double payment for services when the subscriber has health
insurance from more than one source. COB has rules to
determine which insurer pays first.
Utilization management reviews services to ensure that:
A) each line item on a submitted claim is an appropriate
charge
B) they are medically necessary, provided in the most
appropriate care setting, and at or above quality standards.
C) appropriate discharge planning is performed.
D) they are ordered by a physician, provided in the most
appropriate care setting, and exceed quality standards. -
, CCM Multiple Choice Questions with
Complete Solutions (Latest 2025)
Correct Answers ✅Answer: B) they are medically
necessary, provided in the most appropriate care setting, and
at or above quality standards.
Resource: CCMC Glossary of Terms
Rationale: Utilization Management: Review of services to
ensure that they are medically necessary, provided in the
most appropriate care setting, and at or above quality
standards.
The case managers role when working with clients with
substance abuse is to:
A) Motivate the client to change.
B) Support the treatment plan and assist in finding resources.
C) Counsel the client.
D) Monitor for substance use. - Correct Answers ✅Answer:
B) Support the treatment plan and assist in finding resources.
To meet the criteria of medical necessity all of the following
should be present except:
A) It is reasonable
B) It is based on evidence-based standards of care
C) It is appropriate
Complete Solutions (Latest 2025)
All of the following are true regarding coordination of benefits
(COB) except:
A) COB prevents double payment for services when a
subscriber has health insurance coverage from two or more
sources.
B) COB is voluntary.
C) COB determines which insurer pays first when the insured
is covered under more than one health insurance policy.
D) COB coordinates workers' compensation with health
insurance coverage. - Correct Answers ✅Answer: D) COB
coordinates workers' compensation with health insurance
coverage.
Rationale: COB does not coordinate benefits with workers
compensation. COB is a voluntary program that prevents
double payment for services when the subscriber has health
insurance from more than one source. COB has rules to
determine which insurer pays first.
Utilization management reviews services to ensure that:
A) each line item on a submitted claim is an appropriate
charge
B) they are medically necessary, provided in the most
appropriate care setting, and at or above quality standards.
C) appropriate discharge planning is performed.
D) they are ordered by a physician, provided in the most
appropriate care setting, and exceed quality standards. -
, CCM Multiple Choice Questions with
Complete Solutions (Latest 2025)
Correct Answers ✅Answer: B) they are medically
necessary, provided in the most appropriate care setting, and
at or above quality standards.
Resource: CCMC Glossary of Terms
Rationale: Utilization Management: Review of services to
ensure that they are medically necessary, provided in the
most appropriate care setting, and at or above quality
standards.
The case managers role when working with clients with
substance abuse is to:
A) Motivate the client to change.
B) Support the treatment plan and assist in finding resources.
C) Counsel the client.
D) Monitor for substance use. - Correct Answers ✅Answer:
B) Support the treatment plan and assist in finding resources.
To meet the criteria of medical necessity all of the following
should be present except:
A) It is reasonable
B) It is based on evidence-based standards of care
C) It is appropriate
