BCBS Healthselect State of Texas employees

onmywaytoskinny
on 1/20/11 3:36 am - Texas, TX
I have search for this and didn't come up with anything. I don't post a lot....just a long time lurker. But I have a question:

Has anyone had any luck getting approved with BCBS Healthselect for State of Texas employees (ERS)? I am almost finished with my 12 month attempted weight loss requirement and I am just wondering.
onmywaytoskinny
on 3/28/11 6:08 am - Texas, TX
Checkng again! Anyone?
Simone B.
on 3/26/12 4:06 am - Corpus Christi, TX
How did this work out for you? I am in the same boat..but dont know where to start?
bearomar04
on 4/3/12 1:39 pm
Hey guys great news I finished my 12 months and  turned in the required information to the speciaist on January 16, 2012.  On  Feb 13th had to re-submit weight history for 2008.  For some reason they did not get it.    On March 7th I called BCBS for a status report and there was still a question regrarding what was re-submitted, so I contacted the PCP and got a copy of one of my visit in 2008 and faxed it to BCBS.  Called  BCBS on March 26, 2012  and the guy on the other end said "APPROVED' for ghe gastric bypass surgery.  :)    The happiest thing I have heard in a long time.  By the time I got home that day the approval letter was in the mail.  Let me tell you have been trying to get this procedure done for maybe nine years.  Yes,  they do approve you and  all I can say is have all your ducks in a row.  Now I pray the other tests leading the surgery are ok.

 Good Luck in your journey.
Simone B.
on 4/4/12 12:48 am - Corpus Christi, TX
Congrats..I am so glad to hear that someone completed the whole things. My problem is what 12 month weight loss program did you use???
bearomar04
on 4/4/12 12:00 pm
I used my PCP.  I went to him once a month and I was paying that copay monthly.  I had a form that I had made up (from information I got when I was researching),  and I had him to complete it each time. I tried to get in 18 to 20 days each month but sometime there was problems where they were not open or I just could not make there.   It was never at the end of the month.  (I hope I am not too confusing.  I did this for thirteen months - so that there would not be a problem with the number of months.

This form was titled Diet and Exercise Program Progress Note.  I had the following information: Patient is following a ____ kcal/day diet; Patient is participating in the following exercise regimen:____; (walking, swimming, Curves, Yoga, Aerobics, Gym membership, Vitals  Height__ Weight__  HR__ BP__; Changes in wiehgt since last visit___pounds (Lost, Gained, No change); Continue to follow a: ____ kcal/day diet, Other____; Continue to exercise:____;
Other:______

My specialist had a format but it was so simple that I chose not to use.   I just put together the form that worked for me.

 I hope this helps a little. 
Simone B.
on 4/5/12 6:45 am - Corpus Christi, TX
Wow..yes this helps a bunch. I could never find anything online that said what 12 month program they would accept, then I began to worry that if there was a small amount of weight loss following a program that they might still deny someone....I'll have to meet with my PCP and see if he is willing to do this....thank you so much for the information!
bearomar04
on 4/5/12 12:40 pm

Please note the following from BCBS requirements.  It says consective months - do not miss one month or you may need to start over.  You know, I would lose 2 or 3 pounds and gain it back through out the the year.

  • You must have documented active participation in a comprehensive, non-surgical weight reduction program (for example, the BCBSTX weight management program) for at least 12 consecutive months during the 24 months before the date you apply for surgery
bearomar04
on 4/16/12 1:06 pm
Hello World!!!  I have a date yes after trying for over 10 years I am now scheduled to surgery on June 11, 2012.  Pray for me.  I must say I am a little scared but I have waited long enough.  I hope my tests before the surgery are ok.  Again pray for me.
bearomar04
on 3/28/12 1:47 pm
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