Important annual reminders

As a Blue Shield of California plan member, you have a wealth of resources and information at your fingertips once you’re registered on blueshieldca.com. Some of that information includes the below topics we're required to tell you about each year.

When you are registered and logged into blueshieldca.com, you can:

If you’d prefer to receive printed copies of the documents or provider directories mentioned above, just call customer service, the first number on the back of your Blue Shield member ID card.

Other information you might find useful:

  • We are committed to protecting the privacy of your personal information. Our HIPAA Notice of Privacy Practices (“HIPAA Notice”) describes your privacy rights and how we protect, use, and disclose your health information. Our HIPAA Notice has been updated and, if you have not already done so, you should carefully review the revised HIPAA Notice. You can review and print a copy of our HIPAA Notice by going to the blueshieldca.com privacy page. You may also request a copy of our HIPAA Notice by calling the customer service phone number on the back of your Blue Shield member ID card.
  • If you disagree with a decision we’ve made, you have the right to file a grievance. You can call the customer service number on your Blue Shield ID card or log in to blueshieldca.com and go to the file a grievance page. There are instructions on the website and information about how to obtain an independent medical review. There is more information about grievances and independent medical reviews in your Evidence of Coverage (EOC).

    Grievance information from the state Department of Managed Health Care

    The California Department of Managed Health Care (DMHC) is responsible for regulating healthcare service plans. If you have a grievance against your health plan, you should first telephone your health plan at (800) 424-6521 and use your health plan’s grievance process before contacting the DMHC. Using this grievance procedure does not prohibit any potential legal rights or remedies that may be available to you.

    If you need help with a grievance involving an emergency, a grievance that has not been satisfactorily resolved by your health plan, or a grievance that has remained unresolved for more than 30 days, you may call the department for assistance.

    You may also be eligible for an Independent Medical Review (IMR). If you are eligible for an IMR, the IMR process will provide an impartial review of medical decisions made by a health plan related to the medical necessity of a proposed service or treatment, coverage decisions for treatments that are experimental in nature, and payment disputes for emergency or urgent medical services.

    The DMHC also has a toll-free telephone number (1-888-HMO-2219) and a TTY line (1-877-688-9891) for the hearing and speech impaired. The department’s website www.hmohelp.ca.gov has complaint forms, IMR application forms, and instructions online.

    Grievance information from the California Department of Insurance (CDI)

    The CDI is responsible for regulating health insurance. The Department’s Consumer Communications Bureau has a toll-free number (1-800-927-HELP (4357) or TTY 1-800-482-4833) to receive complaints regarding health insurance from either the insured or his or her provider.

    If you have a complaint against Blue Shield of California Life & Health Insurance Company, you should contact Blue Shield Life first and use their grievance process. If you need the Department’s help with a complaint or grievance that has not been satisfactorily resolved by Blue Shield Life, you may call the Department’s toll-free telephone number from 8 a.m. to 5 p.m., Monday to Friday (excluding holidays).

    You may also submit a complaint in writing to:

    CDI, Consumer Communications Bureau
    300 S. Spring Street, South Tower
    Los Angeles, California 90013

    or through the CDI website.

  • You can make a difference by becoming an organ donor. In fact, one person can save or help as many as 60 people. To register, visit Donate Life California.
  • If you’re a woman who has undergone a mastectomy, you’re covered under the federal Women’s Health and Cancer Rights Act for mastectomy-related services, including all stages of reconstructive surgery and surgery to achieve symmetry between the breasts, prostheses, and treatment of complications such as lymphedema. If you have any questions about these benefits, check your EOC, or call customer service.
     

Nondiscrimination notice

Blue Shield of California complies with applicable state laws and federal civil rights laws and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.

Blue Shield of California cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad ni discapacidad.

Blue Shield of California 遵循適用的州法律和聯邦公民權利法律,並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡或殘障為由而進行歧視。
 

Timely access to care

You are entitled to timely access to care. We ask providers to meet these wait time standards.

 

Can't find what you're looking for?

© California Physicians’ Service DBA Blue Shield of California 1999-2024. Todos los derechos reservados. California Physicians’ Service DBA Blue Shield of California es un miembro independiente de la Blue Shield Association. Los productos de seguro de salud se ofrecen a través de Blue Shield of California Life & Health Insurance Company. Los planes de salud se ofrecen a través de Blue Shield of California.

TRUSTe