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Privacy - Contact Us
Privacy - Contact Us

If you are concerned that your privacy rights have been violated, you may let us know by calling the number on the back of your member identification (ID) card. If you do not have an ID card and have a privacy concern you can reach us by calling 877-361-7594.

Written communications can be sent to:

Director, Privacy Office
P.O. Box 804836
Chicago, IL 60680-4110

 
Privacy Forms
Standard Authorization Form (Microsoft Word)
Standard Authorization Form (Adobe pdf)
Instructions for Completing the Standard Authorization Form (Microsoft Word)
Access Request
Disclosure Accounting Request
Amendment Request
Response to Denied Amendment
Confidential Communications Request
Restriction Request
HIPAA Complaint

A Division of Health Care Service Corporation,
a Mutual Legal Reserve Company, an Independent Licensee of the
Blue Cross and Blue Shield Association.
© Copyright 2009. Health Care Service Corporation. All Rights Reserved.

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