Guardian Physician Group

 

Effective Date: 05/01/2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

OUR COMMITMENT TO YOUR PRIVACY

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Guardian Physician Group ("GPG," "we," "us," or "our") is required by the Health Insurance Portability and Accountability Act of 1996 ("HIPAA") and applicable Florida law to maintain the privacy of your Protected Health Information ("PHI"), provide you with this Notice of our legal duties and privacy practices, and follow the terms of the Notice currently in effect.

We reserve the right to change the terms of this Notice at any time. Any changes will apply to all PHI we maintain. The current version of this Notice will be posted on our website at www.guardianphysiciangroup.com and made available upon request.

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WHAT IS PROTECTED HEALTH INFORMATION?

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"Protected Health Information" or "PHI" means individually identifiable health information, including demographic information, that relates to your past, present, or future physical or mental health condition, the provision of health care to you, or payment for that care.

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HOW WE MAY USE AND DISCLOSE YOUR PHI

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GPG may use and disclose your PHI for the following purposes without your written authorization:

 

1. Treatment. We may use and disclose your PHI to provide, coordinate, or manage your medical care. For example, we may share your information with hospitals, physicians, nurses, pharmacists, laboratories, or other health care providers

involved in your care to ensure they have the information needed to treat you.

 

2. Payment. We may use and disclose your PHI to bill and collect payment for the services we provide. This includes submitting claims to Medicare, Medicaid, or other health plans; verifying coverage; obtaining prior authorizations; and coordinating benefits with other payers.

 

3. Health Care Operations. We may use and disclose your PHI for activities necessary to operate our practice, including quality assessment, clinician credentialing, training, audits, compliance reviews, business planning, and customer service.

 

4. Individuals Involved in Your Care. We may share your PHI with family members, friends, or other individuals you identify as involved in your care or payment for your care, unless you object. In an emergency, or if you are unable to agree or object, we will use professional judgment to determine whether disclosure is in your best interest.

 

5. Business Associates. We use third-party vendors to support our operations, including AI-assisted clinical documentation services ("AI scribes"), billing services, and technology platforms. These vendors may have access to your PHI in order to perform services on our behalf. We require each Business Associate to sign a written agreement obligating them to safeguard your PHI in accordance with HIPAA.

 

6. Required by Law. We will use and disclose your PHI when required by federal, state, or local law.

 

OTHER PERMITTED USES AND DISCLOSURES

 

We may use or disclose your PHI without your authorization in the following limited circumstances, as permitted by HIPAA:

• Public health activities (e.g., disease reporting, FDA reporting, child abuse reporting)

• Health oversight activities (e.g., audits, investigations, licensure)

• Judicial and administrative proceedings (e.g., subpoenas, court orders)

• Law enforcement purposes, as permitted by law

• Coroners, medical examiners, and funeral directors, to carry out their duties

• Organ and tissue donation, where applicable

• Research, where approved by an Institutional Review Board or Privacy Board

• Serious threats to health or safety, to prevent or lessen a threat

• Specialized government functions (e.g., military, national security)

• Workers' compensation, as authorized by law

 

USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

 

The following uses and disclosures require your written authorization:

• Most uses and disclosures of psychotherapy notes

• Uses and disclosures for marketing purposes

• Disclosures that constitute a sale of PHI

• Other uses and disclosures not described in this Notice

 

You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

 

YOUR RIGHTS REGARDING YOUR PHI

 

Under HIPAA, you have the following rights:

 

1. Right to Access. You may inspect and obtain a copy of your PHI maintained by GPG. We will provide your records in the form and format you request if readily producible, including electronic copies. We may charge a reasonable, cost-based fee for copies. We will respond within 30 days of your request.

 

2. Right to Amend. You may request that we amend your PHI if you believe it is inaccurate or incomplete. Requests must be in writing and include a reason. We may deny requests in limited circumstances; if denied, you may submit a statement of disagreement.

 

3. Right to an Accounting of Disclosures. You may request a list of certain disclosures of your PHI made by GPG during the six years prior to your request. The first accounting in any 12-month period is free; we may charge a reasonable, cost-based fee for additional requests.

 

4. Right to Request Restrictions. You may request that we restrict how we use or disclose your PHI for treatment, payment, or health care operations. We are not required to agree, except that we must agree to restrict disclosures to a health plan if the disclosure is for payment or health care operations and the PHI relates solely to a service for which you have paid out-of-pocket in full.

 

5. Right to Confidential Communications. You may request that we communicate with you about your PHI in a specific way or at a specific location (e.g., by mail to a particular address). We will accommodate reasonable requests.

 

6. Right to Notification of a Breach. You have the right to be notified following a breach of your unsecured PHI.

 

7. Right to a Paper Copy of This Notice. You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive it electronically.

 

8. Right to File a Complaint. You may file a complaint with us or with the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. We will not retaliate against you for filing a complaint.

 

OUR LEGAL DUTIES

 

We are required by law to:

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• Maintain the privacy and security of your PHI

• Provide you with this Notice of our legal duties and privacy practices

• Notify you following a breach of unsecured PHI

• Follow the terms of the Notice currently in effect

 

CONTACT INFORMATION

 

To exercise any of your rights, file a complaint, or ask questions about this Notice, please contact:

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Privacy Officer Guardian Physician Group 450 State Road 13 North, Suite 106 Saint Johns, Florida 32259 Phone: (904) 659-1899 Email: info@guardianphysiciangroup.com

 

To file a complaint with the federal government: U.S. Department of Health and Human Services Office for Civil Rights 200 Independence Avenue, S.W. Washington, D.C. 20201 Phone: 1-877-696-6775 Online: www.hhs.gov/ocr/privacy/hipaa/complaints/

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