MTM Resources

Download & Print:

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

MTM Policies and Procedures
(116 KB) Download PDF
English

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

Medication Therapy Management Consultation Toolkit

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

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

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

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.
(23 KB) Download PDF
English

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)