Life Medical P.A.

4201 Excelsior ST. Louis Park, MN 55416

Tel : 952 933 8900 FAX : 952-945-9536

www.LifeMedical.US

For PATIENTS

Dear patient,

The following will clarify our billing practice for visits related to medical cannabis certification.

• Initial medical cannabis certification is $250.

• Annual recertification is $200.

• US military veterans get 10% discount

The visit consists of two parts:

1. Medical evaluation and development of plan of care. We review your records, collect medical history and discuss all options for your care, including conventional treatments, medical cannabis and any alternative/complementary modalities that may apply in your case. This part is required by the Minnesota Department of Health. Under the law, the certifying medical provider must provide comprehensive care for the patient’s qualifying conditions, not just certify them for medical cannabis. Besides this being the law, it is also good medicine. This part of the visit is billed to your medical insurance carrier the usual way. The patient is not responsible for any amounts not paid by their medical insurance carrier. All these amounts will be covered from the certification fee.

2. Certification of the patient on the MOH Office of Medical Cannabis webpage as having a qualifying condition.
This part of the visit is charged to the patient directly as above. \t is not billed to Insurance.

The certification fee (part 2) covers the following:

• Initial certification paperwork

» Required follow-up visit charges when they can’t be covered by medical insurance

• Filling out required surveys from MOH

• Legal fees related to the certification program

• All administrative costs covering Minnesota Department of Health requirements for maintenance of approved status for the certifying physician.

« Continued doctors’ medical education for cannabis-related practice.

• Marketing efforts and fees to make the clinic visible by patients seeking certification (maintenance of online presence, advertising, dedicated marketing staff)

Jacob I. Mirman, MD