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Buy and Bill

 

“Buy and bill” is a term used by health care providers when an office or facility purchases LUCENTIS, then bills an insurer for reimbursement. Once the bill is submitted, your office is reimbursed for the product. With buy and bill, you maintain a stock of LUCENTIS, giving you the flexibility to treat your patients when clinically appropriate. If you qualify to continue using the CMS 1500 claim form, follow these steps:

 

  1. Manual bill: Submit a hard copy of the CMS 1500 claim form with J9035 or other code designated by the insurer.
  2. Respond promptly to the insurer’s request for additional information. Failure to submit the documentation before the deadline is a common reason for denial.
  3. Claim is processed. (If denied, see Appeals.)

 

Authorized Specialty Pharmacies

 

Genentech has contracted with a network of authorized specialty distributors and wholesalers to service customers that choose to purchase LUCENTIS® (ranibizumab injection) through the buy and bill model. Customers can purchase LUCENTIS through authorized specialty distributors and wholesalers that have made a commitment to product integrity. These partners have agreed to distribute only products purchased directly from Genentech and not distribute LUCENTIS through secondary channels.

Please contact us for a list of authorized distributors.

Spoilage Replacement Program

 

If the LUCENTIS prescribed for a labeled indication was spoiled and unable to be administered, the product might be eligible for replacement through the Genentech Spoilage Replacement Program.*

 

Potential reasons for replacement

 

LUCENTIS has been reconstituted and is unusable due to one of the following events:

  • LUCENTIS was reconstituted and patient missed appointment
  • LUCENTIS was accidentally dropped
  • LUCENTIS was not appropriately refrigerated or was frozen
  • Patient expired/coded
  • LUCENTIS was not administered due to unforeseen symptoms

 

For all quality- or stability-related issues, please contact Genentech Medical Communications at (800) 821-8590.

 

For expired product returns, please contact Genentech Customer Operations at (800) 551-2231.

 

Replacement procedure

 

To request replacement product:

 

  1. Contact Genentech Customer Operations at (800) 551-2231 to obtain the Genentech Spoilage Replacement Program form.
  2. Complete the Genentech Spoilage Replacement Program form. Please write legibly and fill in ALL required fields to prevent delays.
  3. Fax the form to (877) 329-6737.
  4. The request might take up to 3 business days to review. If approved, instructions for how to return the spoiled product or verify spoilage are provided at this time.
  5. Replacement product ships within 11 business days following receipt of the spoiled product or Certification of Destruction form (provided by Customer Operations).

 

Please be sure to retain all intact vials. Unless the vial(s) is broken, all products must be returned. If the vial(s) is broken, a completed Certification of Destruction form is required.

 

* Subject to certain limitations and conditions. The Spoilage Replacement Program covers infused or injected Genentech products. Genentech has the right to modify or discontinue the Spoilage Replacement Program at any time without notice.
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