Privacy & Confidentiality

COMPLAIN ABOUT A VIOLATION OF YOUR PRIVACY RIGHTS

You have the right to complain if you believe your privacy rights have been violated. You also have the right to complain, in writing, to the Secretary of the United States Department of Health and Human Services at the Hubert Humphrey building, 200 Independence Avenue, S.W., Washington, D.C. 20201. Please note the federal law prohibits retaliation against you if you chose to file a complaint.

The steps to complain about a violation of your Privacy Rights:

1. Obtain a Complaint On Violation Of Confidentiality Or Privacy 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. 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.

4. 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.