Premium Assistance for Kids (PAK)
HIPAA Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please note: This notice is intended for our Medicaid BlueSalud members.
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 to Use or Disclose Protected Health Information (PHI)
- Standard Authorization Form to Use or Disclose Protected Health Information (PHI)
- Request to Access PHI
- Request to Amend PHI
- Request for Accounting of PHI Disclosures
- Response to Denied Amendment
- Confidential Communications Request
- Restriction Request
- HIPAA Complaint
Blue Cross and Blue Shield of New Mexico refers to HCSC Insurance Services Company, which is a wholly owned subsidiary of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association.
