US420DOC Medical Office Reimbursement Agreement
Welcome to the US420DOC Reimbursement Program!
This agreement outlines the terms, responsibilities, and benefits of your participation.
Reimbursement Structure
US420Doc Medical Office Reimbursement Program
Support Patient Access — Comply with Regulations — Receive Reimbursement
Program Overview
The US420Doc Medical Office Reimbursement Program allows licensed healthcare practices to participate in expanding patient access to Georgia’s Medical Cannabis Program. In accordance with the Stark Law and other healthcare compliance standards, your practice will receive a $30 reimbursement for each certified medical record submitted that leads to a completed patient certification.
This is not a referral program. The $30 is strictly an administrative reimbursement for time and effort spent in providing and preparing records used in our cannabis certification process.
Key Compliance Guidelines
Reimbursement is not a referral fee, commission, or kickback.
Payments are provided strictly for administrative services rendered.
Participating offices will be assigned a unique Office ID for tracking and billing purposes.
Patients referred through your office will receive a $10 discount using your Office ID.
Offices must retain documentation per Stark Law and OIG guidelines.
Program Benefits
$30 Administrative Reimbursement for each certified record.
$10 Discountfor your patients.
Monthly Reimbursement Payouts via check or direct deposit.
Billing Transparency:Track payments via unique Office ID.
Access to Patient Resources:Brochures, forms, educational tools.
Dedicated Partner Support:Work directly with a Provider Liaison.
How It Works
Apply online at affiliates@us420doc.com or call (470) 365-8555
Receive your unique Office ID
Submit medical records with your patients' certification process
Patients use your Office ID to receive $10 off
Your office receives $30 for each qualified, certified patient record
Monthly payouts via direct deposit or check
Note: To qualify, records must support a condition approved under Georgia medical cannabis law.
Why Join the Program
This program ensures your clinic is recognized and reimbursed for supporting alternative treatments with transparency and care. It aligns your practice with a compliant, ethical cannabis care model while reducing financial burden for patients.
Website: https://420amp.com
Phone: (470) 365-8555
Email: affiliates@420amp.com
Partner Support: affiliates@420amp.com
By joining, you agree to:
Promote using only approved materials
Avoid false claims or misrepresentation of US420DOC services
Share your QR code in a responsible, compliant manner
Submit a completed W-9 form prior to receiving any payout
✅ Agreement & Signature
By signing below, you confirm that you have read, understood, and agree to the terms of the US420DOC Medical Office Reimbursement Program.