MTM Resources

Download & Print:

MTM Implementation Manual
Guide detailing Humana's MTM program.
(PDF 1691KB) - Download PDF

MTM Policies and Procedures
(PDF 116KB) - Download PDF

Pharmacy Payer Sheet
NCPDP Version 5.1 Payer Sheet
(PDF 98KB) - Download PDF

Medication Therapy Management Consultation Toolkit

Initial Encounter
Script and list of questions that may aid in establishing medical history when scheduling an MTM consultation.
(PDF 23KB) - Download PDF

Initial Consultation
Multipage form that can be used to capture patient information during an MTM consultation.
(PDF 87KB) - Download PDF

Follow-up Consultation
Condensed version of the "Initial Consultation Documentation Form" for use on follow-up consultations.
(PDF 68KB) - Download PDF

Physician Follow-up Fax Form
Inform your patient's physician of the results of your MTM consultations using this form. Note: Please follow your pharmacy's guidelines regarding faxing personal health information.
(PDF 23KB) - Download PDF

Please note that these documents are being provided as an example only. They are intended to be used as a starting point for the development of your pharmacy's own documentation materials. We hope that you take the opportunity to review these tools and customize them for your pharmacy's practice. If you have any questions about these materials, please call Humana's MTM call center at 1-888-MTM-4HUM (1-888-686-4486)