Wiki Hemophilia patients


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Anyone ever bill for medication for hemophilia patients. there is a patient we code J7185 for the type of medication and for Aetna they only alloow 3 digit units so we put J7185x999 until we get to the correct amount of units and in this case the units are 72,000 and that is a 1 month supply. The payer pays only the first 2 lines and denies all the rest as a duplicate. When you look at the EOB the bill is for $94,000 and they pay $2,500 which they say is the contracted rate. I know for a fact they reimburse at $1.27 per unit. Any suggestions on how to get these to pay on the first try?