Right to receive confidential communications

Blue Shield of California communications may contain your protected health information (PHI). You can ask to have Blue Shield communications with your PHI sent directly to you at the mailing address you choose. To make this request, submit a Confidential Communications Request form, which can be found here:

English (PDF, 67 KB)
Spanish (PDF, 71 KB)
Chinese, simplified (PDF, 105 KB)
Chinese, traditional (PDF, 114 KB)
Hindi (PDF, 168 KB)
Korean (PDF, 101 KB)
Vietnamese (PDF, 148 KB)
 

Notice about confidential communications requests:

A health plan shall notify subscribers and enrollees that they may request a confidential communication pursuant to the following and how to make the request.

• A health plan shall permit subscribers and enrollees to request, and shall accommodate requests for, confidential communication in the form and format requested by the individual, if it is readily producible in the requested form and format, or at alternative locations.
• A health plan may require the subscriber or enrollee to make a request for a confidential communication in writing or by electronic transmission.
• The confidential communications request shall be valid until the subscriber or enrollee submits a revocation of the request or a new confidential communication request is submitted.
• The confidential communications request shall apply to all communications that disclose medical information or provider name and address related to receipt of medical services by the individual requesting the confidential communication.
• A confidential communications request may be submitted in writing to Blue Shield Promise at the mailing address, email address, or fax number at the bottom of this page.

Once in place, a valid CCR prevents Blue Shield from:

1. Requiring the protected individual to obtain the primary subscriber’s or other enrollee’s authorization to receive sensitive services or submit a claim for sensitive services if the protected individual has the right to consent to care; and
   
2. Disclosing medical information relating to sensitive health services provided to a protected individual to the primary subscriber or any plan enrollees other than the protected individual receiving care, absent an express written authorization of the protected individual receiving care.
   

You may return this completed and signed form via these options:

Mail: Blue Shield of California Privacy Office
PO Box 272540
Chico CA, 95927-2540

Email: privacy@blueshieldca.com
Fax: (800) 201-9020