Certified Case Manager (CCM) Practice
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
1. The primary goal of case management is to:
a. Increase physician income
b. Improve client health outcomes and reduce costs
c. Enforce compliance with hospital policies
d. Replace the need for healthcare providers
Case management focuses on improving client outcomes while
managing costs effectively.
2. Which of the following is a key responsibility of the case manager
during discharge planning?
a. Administering medications
, b. Coordinating post-discharge services
c. Performing diagnostic testing
d. Writing medical orders
Case managers ensure continuity of care by coordinating follow-up
and community services.
3. Which type of case management model is based on collaboration
among a multidisciplinary team?
a. Brokerage model
b. Managed care model
c. Interdisciplinary team model
d. Independent practitioner model
The interdisciplinary team model emphasizes collaboration across
multiple disciplines.
4. Which of the following is a principle of ethical case management
practice?
a. Loyalty to the payer first
b. Limiting communication with clients
c. Client autonomy and informed consent
d. Avoiding discussion of client goals
Ethical practice supports client autonomy, informed consent, and
self-determination.
5. Which of the following describes utilization review?
a. Monitoring billing accuracy
, b. Evaluating medical necessity and efficiency of care
c. Negotiating insurance contracts
d. Developing clinical pathways
Utilization review ensures care is medically necessary and cost-
effective.
6. When developing a care plan, the case manager should first:
a. Choose service providers
b. Review hospital policies
c. Assess client needs and strengths
d. Approve insurance coverage
Assessment forms the foundation of an effective, individualized care
plan.
7. The most effective communication skill in case management is:
a. Passive listening
b. Giving unsolicited advice
c. Active listening
d. Interrupting frequently
Active listening ensures understanding and builds client trust.
8. A client refuses recommended treatment. The case manager should:
a. Discharge the client
b. Pressure the client to comply
c. Respect the client’s decision and document it
d. Ignore the refusal
, Clients have the right to refuse care; documentation ensures legal
and ethical compliance.
9. A case manager identifies a barrier to medication adherence. The next
step should be to:
a. Report the client to their physician
b. Explore reasons for nonadherence
c. Stop monitoring the client
d. Substitute another medication
Identifying underlying reasons supports tailored interventions.
10. Case management in a managed care organization focuses
primarily on:
a. Billing audits
b. Cost-effective, quality care coordination
c. Marketing health plans
d. Increasing physician caseloads
Managed care emphasizes balancing cost and quality through
coordination.
11. The most important factor when prioritizing case load is:
a. Length of hospital stay
b. Level of client need and risk
c. Insurance type
d. Physician preference
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales
2025|2026 Q&A | Instant Download Pdf
1. The primary goal of case management is to:
a. Increase physician income
b. Improve client health outcomes and reduce costs
c. Enforce compliance with hospital policies
d. Replace the need for healthcare providers
Case management focuses on improving client outcomes while
managing costs effectively.
2. Which of the following is a key responsibility of the case manager
during discharge planning?
a. Administering medications
, b. Coordinating post-discharge services
c. Performing diagnostic testing
d. Writing medical orders
Case managers ensure continuity of care by coordinating follow-up
and community services.
3. Which type of case management model is based on collaboration
among a multidisciplinary team?
a. Brokerage model
b. Managed care model
c. Interdisciplinary team model
d. Independent practitioner model
The interdisciplinary team model emphasizes collaboration across
multiple disciplines.
4. Which of the following is a principle of ethical case management
practice?
a. Loyalty to the payer first
b. Limiting communication with clients
c. Client autonomy and informed consent
d. Avoiding discussion of client goals
Ethical practice supports client autonomy, informed consent, and
self-determination.
5. Which of the following describes utilization review?
a. Monitoring billing accuracy
, b. Evaluating medical necessity and efficiency of care
c. Negotiating insurance contracts
d. Developing clinical pathways
Utilization review ensures care is medically necessary and cost-
effective.
6. When developing a care plan, the case manager should first:
a. Choose service providers
b. Review hospital policies
c. Assess client needs and strengths
d. Approve insurance coverage
Assessment forms the foundation of an effective, individualized care
plan.
7. The most effective communication skill in case management is:
a. Passive listening
b. Giving unsolicited advice
c. Active listening
d. Interrupting frequently
Active listening ensures understanding and builds client trust.
8. A client refuses recommended treatment. The case manager should:
a. Discharge the client
b. Pressure the client to comply
c. Respect the client’s decision and document it
d. Ignore the refusal
, Clients have the right to refuse care; documentation ensures legal
and ethical compliance.
9. A case manager identifies a barrier to medication adherence. The next
step should be to:
a. Report the client to their physician
b. Explore reasons for nonadherence
c. Stop monitoring the client
d. Substitute another medication
Identifying underlying reasons supports tailored interventions.
10. Case management in a managed care organization focuses
primarily on:
a. Billing audits
b. Cost-effective, quality care coordination
c. Marketing health plans
d. Increasing physician caseloads
Managed care emphasizes balancing cost and quality through
coordination.
11. The most important factor when prioritizing case load is:
a. Length of hospital stay
b. Level of client need and risk
c. Insurance type
d. Physician preference
