Tamihott

I am on my 6th month and can't even believe it! It went super fast and it was a good time for me to soak up all the info i could. It was also a good time for me to practice chewing, eating better etc. I do have my down days especially as the time is getting close. You will go through your ups and downs during the 6 months, but I promise it does go faster than you think. The first month is the hardest. I know is sounds cliche, but keep thinking about your new life and how great it will be. This board is the best support system that I could have asked for. Utilize it to it's fullest. You will surely always find someone who is going through the same thing as you are. I wish you the best of luck. Tamara

I just found out that Bc/Bs il paid for my sleep study. My portion was 150.00 out of 3575.00! I am soo relieved. I just find it hard to believe that including the reading of the report the total is over $4000.00 no wonder insurance premiums are soo high!

Congratulations to the both of you. I am glad that things went well. It will be exciting to follow you guys on your journey. Tamara

Good luck. I finish my 6th month this month and I too have bs ppo. Lets hope all goes well. Tamara

Hi, I am from Pa too, I hope to be banded within the next 1-2 months. I am having Dr Bono in Hazleton do my band, who are you going to? Welcome and good luck!

Alegna, Since my dr office has not called me yet to discuss what the actual test results mean, maybe you could help me figure it out. My hypopnea index was 33.9. Impression Considered positive for severe sleep apena with significant amount of oxygen desaturation and sleep disruption. The longest recorded hypopnea was 27.4 minutes in duration. The patient had 129 arousals. 120 were related to respiratory events. There were 125 hypopneas. I think it does not sound good, but maybe you could help. Thanks Tamara

If the hernia is really bothering you and it needs to be done now, I would probably go ahead and do the Lapband at the same time too. I would just get my ducks in a row about the billing and go for it. If the hernia is not that bothersome, then your hubby is right. Jump through the hoops. Bc does expect most of us to just go self pay. We have to show them that we pay good money for our insurance and we intend to use it. Good luck Tamara

I spoke to bc/bs il and asked them about the sleep study denial. They said it was billed out with a diagnosis of Hyerpsomnia not sleep apnea. I had to call the hospital dr office etc and have them write up a referral just in case, and change the diagnosis. They are also going to send a hard copy of the report just in case. Lets hope all goes well. The ins co told me if the diagnosis was sleep apnea it was covered. I would say mild or severe it should be covered. Good luck

My first consult was with Dr Boe in Pa. He orginally practiced out of Chicago Il and relocated beacuse they had such a hard time getting their patients approved. He also stated that Illinois was very difficult to get approvals, but I see lots of people have. I got very discouraged though I live in Pa I have Bc/bs il. Good luck to us both. Tamara

Yes he does surgery at Hazleton general. The good thing was the day of my consult I did my lab work and chest xray right in the same building. Then most of pre op testing appts were right in allentown or near wear I lived. I just thought it to be more one on one.

I have BC/BS of Illinois.

I went to the informational seminar in Allentown as I live in New Tripoli. I was not impressed with some of the things they said and I was not that fond of Dr. Boorse. I was ok with the 6 month thing but alot of the insurance questions I had and the program fee kinda made me wonder if that was the right place for me. I subsequently found dr Bono is Hazleton which is not that far from me and I love him and his program. He is very thorough and personable. As far as the decision between lapband and gastric, you should utilize all the people at LVH and see if someone could talk to you more in depth about the two, only you know what is right for you. Good luck Tamara

Just now I was checking the bc/bs il website, as I have everyday to check the status of the sleep study charge and if and when they were going to pay for it. I was diagnosed with severe sleep apnea and they denied the claim stating "this is not a covered benefit", so tomorrow the fight begins. UGHGHGGH. They suck!!

I agree the 6 month diet thing went soo fast and was a great timefor me to learn all I could about eating and nutrition. I also read and read this site and soak in all I can, so I know what to expect. Like I said before the BC/BS il website is very useful. I would not expect as difficult as they are to get approved there would be any exceptions to the 6 month diet. Good luck. It does go by fast. I am on my 6th month on Wed!!! Tamara

My cardio appt was just a very in depth family history and medical history and an EKG. I am sure that if it is warranted you will be scheduled for additional testing at another date. The pulmo was also family history and medical history. Based on that info then if more testing is needed it is scheduled. I had to have a sleep study. I go tomorrow for the gastro appt and then will be schedule for an upper endoscopy. I am dreading that one the most. Good luck! Tamara

I have not been banded yet, but I wish you a speedy recovery. Congratulations!

I was just on the bc/bs il website and was reviewing my claims to see if they had billed out the sleep apnea test yet and was shocked to see that the pulmonologist had already sent in their bill to read the test and they charged $495!!! It is amazing since they were the last ones to call me about the test. I heard from the sleep center and my surgeon within two days of the test, but did not hear from the pulm until almost two weeks later. I asked them if the dr could talk to me and tell me what the test actually means (I have a copy) and she said well he is out of town for another week!!

I have bc/bs illinois and it clearly states (I have read it with my own eyes) that they use the BMI from the 1st date of your 1st appt! Yeahh! Tamara

I had my sleep study done two weeks ago, as you know I also have BC/BS il. I was like you and kind of wished something would show up. I was not even worried about them paying until I saw your posts. When it was confirmed that I have severe sleep apnea, I was in tears. It is a scary thing that I wish I did not have to deal with. In the long run I am glad that I know and I am sure it will not hurt my approval process, but I could do without. I go back for the CPAP study on the 16th. I dread that I have to wear that mask and have a machine to sleep, considering that I don't sleep well now. You have to have "clocked" soo many hours on it, before that surgeon and anesthesiologist will even do the surgery. Just another thing to wait for. Good luck. Tamara

Wow!! There really may be hope for us all. Thanks for the positive post about BC/BS of illinois. I am sure we were all in need of that boost! Tamara

Did you have to include a 5 or 3 year weight history ? I was curious as right now I am getting all my stuff for my packet in order as I am on my last month of my 6 month suprervised diet. Thanks

Have you ever tried to go onto bcbsil.com website and look up the medical policy on the sleep study. I just had a sleep study and then after the fact decided I would check to see if it was a covered benefit!! Duh! I went on the website and got all the info I needed. It looks to me that I will have no problem with coverage. If you need any help lookin up the info just shoot me an email!

I had my sleep study a week ago and I did sleep only due to the fact that I took an Ambien. My tech said they need 5 hours of data which does not have to be sleeping. They called me by Wednesday and gave me my results. Unfortunately I have severe sleep apnea and will go back for a CPAP study. So for me I will have to do it all again! Good luck! Tamara

Really since my decision I have had mutliple moments. Some of them being breaking my moms toilet seat, an at least 400lb woman on tv and my 2 yo saying "look Mommy". The fact that I just found out I have severe sleep apnea. My worry if this will be the time I will have to get a seat belt extender on an airplane. My recent trip to Seaworld not wanting to go on the rollercoaster, just because I was afraid I would not fit and then trying to convince my 16 yo that I no longer like rollercoasters!! I really could go on and on but it is just very sad for me to think at 34 I have such worries!

I was just on the medical policies section of the bcbsil.com website and did not see any new updates or changes to the approval criteria. I have not heard of the high BMI rule that you do not have to do the 6 month supervised weight thing. Good luck! I hate bcbs ill