Privacy and Confidentiality

REQUEST TO ACCESS INFORMATION

You have the right to review your records contained in Carolina Care’s Designated Record Set (DRS). A DRS is a summary of all your protected health information that Carolina Care has about your eligibility, claims, customer service, care management and prescription information. If you would like to access your entire medical record, you will need to contact the provider of the service.

The steps to request Access are:

1. Obtain a Request For Record Set Form by clicking on this link or by calling Customer Service for this form at the telephone number on the back of your identification card.

2. Complete this form including all pertinent information.Please note that Carolina Care will not be able to process an incomplete form and you will NOT BE NOTIFIED if this situation arises.

3. Keep in mind as you are completing the form that if you are requesting records from a phone call to Customer Service, you must include the date and time you called Carolina Care. If you are requesting claims information, you must include the claim number, date of service and provider.

4. Sign the completed form and send to:

Carolina Care Plan PO. Box 100234 Columbia, SC 29202-3234

NOTE: If you obtained your form at our website, please print it out when completed. All requests must have a signature and be sent to the address above. Requests will not be excepted if sent via email.

5. When your request is received, the necessary steps will be taken by the Carolina Care Staff to send you the information in a reasonable time frame.

NOTE: You may send your request in writing instead of using the Privacy & Confidentiality Form, but the request must include: your name, your birthday, the policy number under which you are covered, the group number under which you are covered, your social security number, the information you would like to access and the dates of information you would like to see (if applicable). Again, please note that Carolina Care will not be able to process a request that does not include all the necessary information and you will NOT BE NOTIFIED if this situation arises