Anybody have Mississippi State Employee Insurance - BCBS AHS Network

[ItsTime4Change2 0]

Does anybody here have the Ms State Employee Insurance? I am looking at the policy documents and I feel a little bit like I am reading the tax code.

Is there a clear cute plan of action that anyone has followed to get approved?

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[lindseygray23 0]

Yes you have to do 6 months of coaching and weigh ins with your pcp and have medical records from the past 5 years What part of ms are you from?

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[ItsTime4Change2 0]

I'm in north Ms. I regularly see a nurse practitioner as my primary care. I wonder if I'll have to use an MD for this.

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[lindseygray23 0]

I use a np for mine as well. Where are you located?

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[ItsTime4Change2 0]

Sent you a private message.

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[JoJo_C 38]

I am under the impression that you could do 3 months in clinic weight loss program, or do the 6 month active health program.

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[ItsTime4Change2 0]

I hear you JoJo. And I totally understand that interpretation of the plan documents. I spoke with someone at length who just went through the surgery with the state insurance. They were required to do more than that. There is a bariatric coordinator at the hospital I plan to use that works with the insurance to help get patients qualified. I am supposed to talk to that person this week and I will let you know what she says has been required for approval.

I am under the impression that you could do 3 months in clinic weight loss program, or do the 6 month active health program.


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[JoJo_C 38]

The coordinator at my WLS clinic, says they have done a lot of state employees and it's one or the other. I am supposed to have my first call today with active health, but am going to cancel it until I can get a clear picture from my clinic.

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[ItsTime4Change2 0]

Who are you using jojo?

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[ItsTime4Change2 0]

I am using Baptist Hospital and Dr Byars

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[JoJo_C 38]

Transitions at river oaks. My surgeon will be Doctor Carroll

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[ItsTime4Change2 0]

I have not heard from the coordinator's office yet. I may end up just showing up and trying to get a face to face. Looking at the plan documents, it does say...

"Member must meet one or more of the following criteria:

• Physician-supervised nutrition and exercise program.

• Multidisciplinary surgical preparatory regimen.

• Participation in the Weight Management Program."

​I just wonder what determines if "or more" is needed.

Edited January 11, 2017 by ItsTime4Change2

[JoJo_C 38]

I spoke with active health today. If you are doing 3 month multidisciplinary surgical prep regime then that's all you have to do. I am seeing internist, nutritionalist, and exercise physiologist.

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Edited January 11, 2017 by JoJo_C

[JoJo_C 38]

Oh course you have to do post op follow up with active health.

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[ItsTime4Change2 0]

Gotcha. Thank you for the update.

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