The End of a Saga – Reimbursement of Out-of-Pocket Expenses

“Persistance pays off. Sometimes it’s even okay to be annoying because you will get what you want” – my dad

 

After 9 months…I will get my money back! If you are new to my blog, I will give a little review (you can read my experience in more detail here). I started sitting for the monthly Orencia IV infusion in September 2013. Since I already paid the deductible on my insurance, all my medications were covered. At the end of March 2014, I received a surprise 2-month delinquent bill for an invoice from January. It totalled more than 800 dollars and attached with a lovely note telling me they would stop my medication shipments. There are so many more issues with this but the one that really bugged me was my credit score. They were sending me the invoices, albeit to an address I have not lived at for TWO years, but because they thought I was ignoring them my credit score plummeted. I had fabulous credit before this. And, as you probably know, it takes patience and time to build good credit but only one missed payment to shatter it.

 

ANYWAYS…

I re-applied for co-payment assistance immediately. I contacted Accredo, gave them the new membership ID and asked them to backdate the invoices.

After more months of clerical mistakes, I still paid out of pocket so in July I started over.

I re-re-applied with Orencia IV Infusion co-payment assistance online, got a new membership card and after weeks, yes, weeks, found a manager at Accredo. There was a note on my account “if client calls again, tell them to call insurance provider”. I was so angry, I yelled at the supervisor. “This is not their issue, it’s Accredo’s for not applying the right information and sending the invoices to the WRONG co-payment assistance!” The manager “sat” with someone in the Billing department as they re-entered my new membership information and promised to re-send the invoices “to the right place”. Up until this point, they were sending them to Remicade co-payment assistance. (I HAVE NEVER BEEN ON REMICADE, if that gives you a sense of how INCOMPETENT this pharmacy is)

PS. I still do not know where they are sending those invoices but it is certainly not to Orencia.

 

I called Orencia to find out if they had received the invoices and they said no. However, Accredo had filed my benefits through the card on file and the May invoice was rejected. Why?

 

Because Orencia has a 45-day back-date policy.

 

I almost started crying on the phone to the Orencia rep. I was devastated and very annoyed. I wanted to file a complaint with the Maryland Insurance Administration. I was obviously not getting anywhere on my own and I needed legal help.

 

But something came to me, I asked her “I signed up for the new Assistance program in March through my doctor’s office. Where is that information?”

“It’s not showing that you were a member before July.”

“I was, I never received a card but I did recieve a membership number. Where is that information?”

Now, it’s important to know I talked with this specific representative at least three times since this ordeal began. She remembered talking to me in April “Wait a minute, let me go through your account…I would not have even talked to you in April if you were not a member”.

She went through my history with a fine-tooth comb and noticed a mistake in the notes. I had signed up with the IV copayment assistance program in March, with validation from my doctor’s office. For whatever reason, that membership information had not transferred to my account.

The representative contacted management and placed a request for exemption. It turned out it was a mistake on Orencia’s end so they accepted the exemption and agreed to reimburse me every single invoice from the beginning of the year, even though the January one was a little out of the 45-day bracket.

 

I kept repeating “thank you so much, if you hadn’t remembered talking to me before the May invoice, if you had not gone through my history the way you did, I would not be getting my money back.”

It’s amazing how just a little customer service goes a long way.

 

…But, there was a snag. (of course, right? It just cannot be that easy…)

Accredo did not send them any of the invoices, they could not do anything without those invoices.

I fished around through my bills from the last year and found every one of them.

…But, there was an even bigger snag.

 

They were not in my name. I am still under my father’s insurance so the invoices were sent in his. Also, the medication name was not even on them! They just showed the coverage adjustments.

The representative told me to fax them anyways. If they could not use them they would let me know.

Just in case, I called Express Scripts and asked them to re-send an itemized invoice in MY name.

 

I called a couple of times last week because Orencia was still processing the invoices and they had neither been rejected or accepted yet.

On Monday, I ended up speaking with this amazing representative again and she told me the checks had been sent out. I asked her the value of each check and I was so pleased to find out I am getting everything back. Well, everything minus $20, which is what I was only supposed to spend over the last 9 months. How much did I spend? Over $1,000.

 

I am not going to lie to you guys. I am exhausted. I was on the phone with Orencia, Accredo every week sometimes twice a week. The strain and stress of the situation put me right to sleep and I napped most of the day. I was close to my breaking point and I was ready to file a complaint.

But now, this is behind me. I re-start the Orencia IV again next week. These past two months have been pretty bad without it (which I will talk about in another post).

 

Persistance, my friends, does pay off. I’ve always been one to beat anything into the ground. My father usually says I am less persistent, more pig-headed than anything else…hey, if it works, right?

 

Hi, my name is Monica and I have RA.

31DC2014 – September 17: Glitter, Pirate Nail Art Challenge – Treasure/Gold

Perfect timing! “All that is gold does not glitter”…but let’s face it, pirates like their treasure shiny. Initially I wanted to re-create my 31DC2013 – Inspired by Eye Makeup I Love manicure (linked here) but nearly forgot dragons were not the theme…Treasure-hunting was so I swapped the giant reptile for a full wooden chest.

I kind of love how this came out, especially the gradient base, the yellow really makes the gold pile kind of glow! I hope you like it too!

 

31DC2014 - September 17 - GlitterA list of the polishes:

  • Color Club Wham! Pow!, Almost Famous
  • Zoya Goldie
  • Sephora by OPI 212-Sephora
  • Revlon Parfumerie Fresh Linen
  • Yellow, red, brown acrylic paint

A list of the tools:

  • makeup sponge
  • assorted artist’s brushes

 

Hi, my name is Monica and I have RA.

 

Check out the other glitter nail polishes below!

 

 

…And don’t forget to check out the pirate treasure manicures below, too!

31DC2014 – September 16: Geometric

For this prompt, I wanted to mix strong geometric lines with abstract art. I really like how this came out and it was exactly what I wanted. I do not wear glitter toppers that often and I definitely need practice applying it! The tips of my nails and I seem to be on the outs right now!

 

I hope you like it!

 

DSCF0924_fotorI used 3 coats of American Apparel Parakeet. I can usually get away with 2 coats but because of the saran-wrap technique I wanted to make sure I had enough.

Next, I used cling-wrap, Zoya Yara and Giovanna. The saran-wrap technique is great #rafriendlynailart!

I stamped with Milani Black Swift and Bundle Monster plate BM-322.

I used a couple of coats of Serum No. 5 Forest Lights for my accent.

 

Hi, my name is Monica and I have RA.

 

Don’t forget to check out the other geometric prints below!

#31DC2014 – Day 14, 15: Flowers, Delicate Print

Once again, I fell behind because of fatigue so I squashed the flowers and delicate print together. What screams delicate more than distressed nails! I did them in pink, that makes them more delicate, right? :P

Anyways, I used a “delicate” flower stamp to combine both prompts.

I hope you like it. I really love distressed nails. I especially like the thicker, less cracked look and the American Apparel polish was the absolutely perfect consistency! So much hardcore love for this polish!

 

31DC2014 Challenge - Day 14,15: Delicate FlowerI started with 2 coats of Sally Hansen Insta-Dri Petal Pusher as my base.

I “distressed” with American Apparel Neon RedColor Club Pop-tastic and Milani Mauve Medley.

I sealed the design with a generous coat of INM Northern Lights (Gold) before double-stamping with MoYou London plate 09 Pro collection, Konad Special Polish Red and Milani Color Statement Spotlight White.

 

Hi, my name is Monica and I have RA.

 

Check out the other delicate manicures below!

Short Update of VERY VERY VERY Good News and a Celebratory Giveaway

I am a very happy Monica today! Look forward to a happy ending post on Wednesday! Reimbursement finally came through. The saga ended! I am getting ALL my money back.

YES.

All of it!

After 9 months, I will be reimbursed! I will re-count the epic, yes, EPIC (where generally people die at the end) tale of getting my money back.

I am so so so excited! This is not just they told me the invoices were processed and they will send the money. They have sent the money. The checks were posted in the mail on SEPTEMBER 9TH, 2014.

 

In other news…

 

On the 7th of September, 2014 I reached 100 subscription followers on my blog! Wow! I always prefer quick and instant gratification (who would ever said I don’t want that now, I want it in one year?) but I know big goals take time and persistence. For one year of nail art blogging, I am thrilled to have received 100 followers! I know my posts are not up to scratch because of flares and fatigue, and I disappear for short periods of time. I feel like I am not putting out my best work sometimes so I really appreciate you sticking with me through all of that! I’ve been considering a giveaway for some time and now is the best time to do it!

 

In celebration of all of the above…

 

I have not finalized what will be in the giveaway yet but it will contain some nail goodies and some RA-inspired goodies too! I want to keep it small so I can open the giveaway internationally!

I will use Rafflecopter to accept entries so expect more information on that in the next couple of weeks!

 

Seriously, thank you everyone!

Hi, my name is Monica and I have RA.

Challenge Your Nail Art (9/15 – 9/19) – Pirates: Sea Creatures

Jessica over at Be Happy and Buy Polish hosts one of my favorite challenges. They are bite-size and last no longer than 4 days. She polls the Facebook group for the most popular prompts and compiles the top themes. Jessica hosts a different challenge every few weeks. I find these challenges more hardcore than daily monthly challenges because the themes are more unique and specific.

I cannot tell you for sure if I will complete each day (be prepared for a double 31DC2014 manicure tomorrow) but I will certainly try.

I hope you like my sea creatures manicure. I especially like the double stamping of bubbles. This look was loosely inspired by Pandora, the National Zoo’s late  Giant Octopus, who passed away last February. Unfortunately since then, the Invertebrate House has lost even more funding and was shut down a month or two ago.

 

Pirate's Nail Challenge (9/15): Sea CreaturesI made a gradient using a make-up sponge, Sally Hansen Blue My Mind (cuticles) and Zoya Dream (tips). I sealed the gradient with INM Northern Lights (Silver).

I double-stamped bubbles with Milani Power Periwinkle, Peacock and MoYou London plate 08 from the Sailor collection.

I used MoYou London plate 04 from the Princess collection and Essie No Place Like Chrome. I love stamping with this polish but it shows every little flaw!

 

Hi, my name is Monica and I have RA.

 

Don’t forget to check out the other sea creatures below!

#31DC2014 – September 10, 11: Gradient Dotticure

I cheated and combined two prompts, but I was also running behind so what better way to catch up?
I went with a purple gradient today with some purple dots to hide the bubbling from the top coat!

I hope you like it!

 

DSCF0873_fotor-001I used 3 coats of Milani Power Periwinkle as my base.

For the gradient, I used a makeup sponge, Milani Power PeriwinkleSephora by OPI Domestic Goddess and Caffeine Fix.

I dotted with the same Milani polish.

 

Hi, my name is Monica and I have RA.

#31DC2014 – September 12: Stripes

Sorry about the not so great lighting, I’m trying to find better over the weekend!

I’ve fallen a bit behind because on day 10 I experienced a hit of exhaustion. I wanted to incorporate day 10 and 11 but everything I tried was a real nail fail and I lost steam quickly. I have an idea of what I want to do and hopefully it turns out how I want!

Anyways, here are my stripes for today…I am really stretching the prompt but as I see it, the design is made of up stripes, right?

I hope you like it. I am a little annoyed though, I sponged the base but it just came out like I smeared the stamp :(

 

DSCF0861_fotorI used 3 coats of Zoya Goldie as my base. This time I actually remembered to use the shimmer-y polish as my base so clean up was so much easier!

I sponged with Sinful Colors Chick Chick and Julie G White Orchid. 

I stamped with MoYou London Back to the 80s plate 02 from the Time Travelers collection.

 

Hi, my name is Monica and I have RA.

 

Check out the other stripe manicures below, there are some real stunners in the collection today!

#31DC2014 – September 9: Rainbow

For someone who loves neons, colors and brights it is a surprise I have so much trouble with rainbow prompts. As you know, I am not a fan of the traditional rainbow scheme but it is the only inspiration that comes to mind. Many people did lovely sugar-spins and gradients and everything else I could think of so I was at a loss. Of course, it isn’t a problem to do the same thing as other people and it is bound to happen during a daily challenge but who wants to look at the same thing multiple times?

I was literally sitting on the floor at 8pm staring at my nail polishes and other art tools and my brain shut off. I had no idea what to do. I turned around and put away my new shoelaces which had just come in from Converse when it hit me. Inspiration from my shoelaces (You’ll see what I mean below!) Not exactly “rainbow” but it will do for being totally stuck on a prompt for two days!

I hope you like it! Apologies on the sub-par photograph. I could not get my camera to focus on both the shoelace and nails, I tried to choose one that sort of showed both. In retrospect, I should have chosen the nails over the laces. Oh well, lessons for next time!

 

DSCF0848_fotor-001I used 2 coat of Wet n Wild Black Creme.

I dotted with Color Club Poptastic, Wham! Pow!Almost Famous, Pop Beauty Pacific Hoot and Revlon Gel Envy High Stakes. I was thrilled to find I had the exact nail polish matches for each color on the laces. The teal photographed bright on the laces but please take my word for it, they are matches!

 

Hi, my name is Monica and I have RA.

 

Check out the other rainbow manicures below!

August Favorites – Showcase

Each photo links to original web post.

May contain affiliate links.

It is time for my favorites showcase! Last month I switched my monthly favorites to a monthly showcase. I put my Pinterest addiction to good use and started a “favorites board”. Two, actually, one for nail art and one for everything else (ie. products, etc). Check out my August nail art board here and my items board here.

I picked ten from both boards. This is not to say I like any better than others!! If I talked about every nail art and item I would go on forever so please check out all my favorites at the links above!

 

 

DSCN6219Is it any surprise I adore this manicure? It is a surprise I have never attempted a manicure like this though! Heather from Peace, Love & Polish did such a great job. The colors and details remind me exactly of doggie day cares! The extra shadows are the main reason I love Heather’s work; her eye for detail push her nail art from just pretty to amazing.

 

House-of-flying-daggers-bamboo-nail-art-501I am always in awe of Ali’s freehand work. She thinks of every possible detail and executes each perfectly. I am really jealous because I wish I could create as lovely a landscapes manicure but until and after I can I will continue to moon over hers! The background has so many levels, the shading is amazing and because of them her art has a 3D feel.

 

_6235088I bought this highlighter at the beginning of Summer 2013 when it was LE. This was my first highlighter purchase, ever.  It is bronze with a faint rose gold shimmer. Up until I found this highlighter, most were too gold or pearly for me. This is appears more gold on the skin and as with most Chanel products, the shimmer is noticeable.

Over the last month the inflammation in my eyes got worse. I barely tolerated contact lenses and less than managed eye makeup. I was not sleeping well because of the pain. I looked tired and ill. A dab of this highlighter on the corner of my eyes, under the brow bone and on the bridge of my nose “woke” me right up!

A little product goes a long way, I haven’t made it halfway through the bottle! The opening of the bottle is big and the product is thin so I have to be careful about spilling or taking too much (both have happened on numerous occasions) but it is easy to blend in and sets quickly. Once it sets it does not budge, even in hot weather!

075b3a081725463a8fd14cd2f66d35a0

Even when I cannot wear eye-makeup I still want to look put together and blue mascara is the perfect way to do so! Colored mascara was all the rage a few months ago. I tried a fair few and I did not like any of them. I bit the retail bullet and tried the YSL “Shocking” mascara. I fell head over heels. I heard good things about the “Babydoll” line so on a whim, I purchased Audacious Blue. It became my every day mascara. Navy blue brightens the whites of the eyes and instantly perks up my face. Unlike most other mascaras I’ve tried, I can tell the product is on my eyelashes. In certain lights, I see the color but not in an “I am wearing mascara” type of way. It mimics natural navy blue highlights on super shiny black hair. This mascara lengthens and separates my lashes so they look like a better groomed version of themselves. Best of all, the mascara does not flake, even when climbing!

Wow! What else can I say about Ruth’s amazing Halloween manicure! The gradient and stamping are clean and the scary eyes are a very sweet touch! I fell head over heels for this manicure when I first saw it and expected nothing less! Ruth’s nail art is extremely unique and her photography is to die for! Each picture has a little extra. I am not one to look at multiple pictures of the same thing but I find myself scrolling down the posts on the Adorned Claw!

967863c9e19f0a0eee2a28c3fc6715e3I was instantly drawn to Sammy’s blog because of her short nails. As I followed her on a regular basis I fell in love with her simple yet gorgeous designs. Sammy gives me endless inspiration for my own nails and when I saw her watercolor plaid designs, I knew I had to take note. Plaid and water-color? How can anyone go wrong? The Nailasaurus certainly doesn’t! The look is pulled together by the deeper spots on the tips. Even application of the water-color technique is difficult and it just goes to show Sammy’s level of detail!

117a35909df11eb47418473e537b9444Bubbles!! I am actually five years old and bubbles. Blowing bubbles was my favorite pastime as a kid. My parents were totally okay with that because hey, it was easy and kept me busy for hours! Want to hear a funny story? Marmalade is TERRIFIED of bubbles. It is very funny and sort of sad. Sometimes I wonder how she is my cat.

I was drawn to Laurie’s manicure because of the colors and the 3D feel. The “greater than” gradient across the nails mimic a moving picture, if that makes any sense. I thought I was watching someone blow bubbles, true nail art!

4947129bb948c723f5a8b966d0cb00e9In my opinion, Shelly never fails at nail art. Her designs are gorgeous and well-executed. And her nail shape is always on point. Her nails always look perfect! This manicure is amazing because of the depths of the waters and shore, the little critters are a cute, pretty touch and the crowning piece is the textured sand at the tips.

Under Armour "Ultimate" Shorts | @NordstromYou may remember these lovely pair of shorts from my Nordstrom anniversary sale post and let me tell you, I love them! I bought them both in blue and green and would have in pink if they came in my size. These are the only pair of spandex shorts I own. I’ve always had trouble finding a pair that fit. They would either fit in the rear, but not at the hip or would just be too big all the way around. Usually, the legs are too loose which is my biggest pet peeve about leggings. They need to be tight fitting and have no gaps.

These shorts fit me perfectly, they are thin, lightweight and they show no lines. They may not be seamless but they certainly act that way!

Sailboats by Will Paint Nails for Food | The Rite of Aging Monthly FavoritesMeghan’s gorgeous freehand mimics a canvas painting. This specific manicure was inspired by a painting but that is besides the point! Meghan’s layering gives her nail designs a true artist’s feel. I can never achieve the same level of depth and detailing without the design coming out one gloppy mess. Meghan uses a mix of nail polish and acrylic paint but her artistry looks like pure paint, always.

I hope you like my August showcase. This post took me so long to write because I kept switching and changing the nail art I featured. There are a ton more at my Pinterest page so don’t forget to check them out!

Hi, my name is Monica and I have RA.