Perform an MTM Intervention
 
INSTRUCTIONS:

1. Complete a Comprehensive Medication History (CMH) Interview Form - Click HERE


• DATA COLLECTION
• Pharmacist Documentation
• Listen to the patient interview.
• Fill out the CMH interview form while listening to the interview.


2. Complete a Comprehensive Medication Review (CMR) Worksheet - CLICK HERE


• DATA ANALYSIS
• Pharmacist Documentation
• Complete ALL sections of this worksheet.
• It is intended to help guide the pharmacist in analyzing patient data gathered during the CMH interview.


3. Complete all three Patient Documentation Forms and submit electronic CMR documentation - CLICK HERE


• DATA REPORTING
• Patient Documentation
• Reimbursement for pharmacist services requires the patient be given:
1. Cover Letter (CL)
2. Medication Action Plan (MAP)
3. Personal Medication List (PML).
• Complete the electronic CMR documentation and print a hard copy.

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Pharmacy Computer System - MTM Services Software