Request For Personal Information
Occasionally, individuals may have personal information they wish to review in the Department's records. Such information usually consists of:
- A complaint concerning an enrollee's health plan, as submitted to the Department
- The health plan's response to the enrollee's complaint
- The results of an Independent Medical Review regarding denial of treatment for an enrollee
Under California's Information Practices Act of 1977 (IPA), Civil Code §§ 1798 et seq., the Department must strictly protect the confidentiality of any personal information in its records, such as an individual's name, address, social security number, and medical information. For that reason, people who request personal information must provide proof of identification before the Department can release the information to the individual or his or her authorized representative.
How to Request Personal Information
Requests for personal information must be made in writing and should clearly specify the records sought. Requestors must verify their identity when seeking to view their records, either through a notarized signature when requesting mailed records or by presenting official identification when examining records in person. To request either method of viewing personal records, please print out, complete, and submit to the Department the form below
The Department will allow inspection or provide copies of responsive documents within 30 days of receipt of the request.
How to View Personal Records
Requestors may inspect personal records in person, or ask that photocopies of the records be mailed either directly to them or to their authorized representative.
To inspect records in person, the requestor must schedule an appointment by phoning 916-322-6727. At the time of the appointment, the requestor will need to show a government-issued identification card. Photocopies of the records can be made at that time for a fee of $.10 per page.
To have records mailed, the requestor must send the Department an original letter, not a facsimile, or a printout of a completed Request for Personal Information Form. The letter or form must be signed, and a notary public must verify the signature.
Attorneys or other representatives must present proof of authorization to the Department before an individual's personal records will be mailed to the representative.