The HIPAA Privacy Rule protects most individually identifiable health information held or transmitted by a covered entity or its business associate, in any form or medium, whether electronic, on paper, or oral. The Privacy Rule calls this information protected health information (PHI)2. Protected health information is information, including demographic information, which relates to:

For example, a medical record, laboratory report, or hospital bill would be PHI because each document would contain a patient's name and/or other identifying information associated with the health data content.

By contrast, a health plan report that only noted the average age of health plan members was 45 years would not be PHI because that information, although developed by aggregating information from individual plan member records, does not identify any individual plan members and there is no reasonable basis to believe that it could be used to identify an individual.

The relationship with health information is fundamental. Identifying information alone, such as personal names, residential addresses, or phone numbers, would not necessarily be designated as PHI. For instance, if such information was reported as part of a publicly accessible data source, such as a phone book, then this information would not be PHI because it is not related to heath data (see above). If such information was listed with health condition, health care provision or payment data, such as an indication that the individual was treated at a certain clinic, then this information would be PHI.

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Search for a primary doctor or find a specialist covered by your plan. To ensure maximum coverage and avoid surprise bills, be sure to confirm that the doctor is in your Blue Shield Promise network.


In order to participate in the California Children's Services (CCS) Program as a provider, you must have a National Provider Identifier (NPI) enrolled with Medi-Cal.


Hospitals where a doctor can practice and admit patients. A doctor can be affiliated with several hospitals.

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Did you know? Blue Shield offers free American Sign Language and face-to-face interpreting services for all providers. Advance notice is required. To request services, contact Blue Shield Promise Medi-Cal Member Services at (800) 544-0088 (TTY: 711). Read about language services here.

You may receive services from any provider in your primary doctor's medical group. Some services need a referral.