CCMC Cheat Sheet 2026

The 30 highest-yield CCMC facts, distilled from real exam questions. Print it, save it as a PDF, or study it here — free, no sign-up.

1. Under the Americans with Disabilities Act (ADA), what is an employer required to provide to a qualified employee with a disability? → Reasonable accommodation unless it causes undue hardship
2. Which federal law requires health plans to establish an internal and external appeals process for denied claims? → The Affordable Care Act (ACA)
3. Case Management is what type process? → Collaborative
4. Which federal agency enforces workplace safety regulations and standards designed to prevent occupational injuries and illnesses? → Occupational Safety and Health Administration (OSHA)
5. When a payer denies a claim for lack of medical necessity, the case manager's FIRST step should be to: → Review the denial reason and gather supporting clinical documentation
6. In workers' compensation case management, what is the PRIMARY goal when coordinating care for an injured worker? → Facilitating recovery and safe return to work as early as clinically appropriate
7. Social Security Disability Insurance (SSDI) requires that an applicant's disability must be expected to last at least how long or result in death? → 12 months
8. A case manager identifies that a client qualifies for the Supplemental Nutrition Assistance Program (SNAP). Which federal department administers SNAP? → Department of Agriculture (USDA)
9. What computer-based system is designed for collecting, storing, manipulating, and making clinical information important to the health care delivery process? → Clinical information system
10. The first thing for the case manager to do when a client is not compliant with the plan of care is to: → Discuss barriers to compliance with the member.
11. Which type of rehabilitation service focuses on improving a patient’s ability to perform activities of daily living (ADLs)? → Occupational therapy
12. Concurrent utilization review is performed: → During the course of treatment or hospitalization
13. Retrospective utilization review is MOST useful for: → Identifying patterns of over- or under-utilization after care is delivered
14. What is the primary purpose of utilization management in case management? → To ensure appropriate use of healthcare resources while maintaining quality
15. A 'peer-to-peer review' in utilization management involves: → A treating physician speaking directly with a medical reviewer to discuss a denial
16. Which of the following is a common reimbursement model used in healthcare? → All of the above
17. An elderly client living alone needs transportation to medical appointments. Which community program MOST directly addresses this need at low or no cost? → Medicaid non-emergency medical transportation (NEMT)
18. Which of the following made by a nurse on information technology needs further correction? → "It enables us to disclose information to anybody."
19. Which community support model pairs a professional case manager with a peer support specialist who has lived experience with the same condition as the client? → Assertive Community Treatment (ACT)
20. Which federal housing program provides vouchers that allow low-income individuals and families to rent privately owned housing? → Section 8 Housing Choice Voucher Program
21. Which case management function involves identifying formal and informal community supports and linking clients to those resources? → Resource identification and referral
22. Which of the following is a primary goal of implementing a case management information system for quality and outcomes evaluation? → To facilitate data collection, analysis, and reporting for performance improvement.
23. Which type of disability benefit replaces a portion of income for employees unable to work due to a non-work-related illness or injury? → Short-term disability (STD) insurance
24. A case manager is helping an uninsured patient access prescription medications at low or no cost. Which resource is MOST appropriate to recommend? → Pharmaceutical manufacturer patient assistance programs
25. Which of the following is a primary goal of rehabilitation in case management? → To restore the patient’s functional independence
26. Which of the following is a key component of a comprehensive rehabilitation plan? → Multidisciplinary team approach
27. What does 'level of care' determination refer to in utilization management? → The assessment of the appropriate care setting based on a patient's clinical needs
28. In the context of rehabilitation, what does the term "neuroplasticity" refer to? → The brain’s ability to reorganize itself by forming new neural connections
29. Raising the height of a desk to provide access by a wheelchair is an example of a: → Job accommodation
30. It measures the reliability, integrity, and performance of the system. This refers to? → Dependable System