HIPAA Compliant Fax Solutions
Posted by MutiaraNaga@reddit | sysadmin | View on Reddit | 43 comments
A healthcare agency is currently limited by their fax solution (10MB per fax with issues sending faxes above 100 pages). The current VoIP provider has a higher file size limit of 95MB but each file must be 50 pages or less.
I'm looking for recommendations for a fax service which would accommodate 250+ page faxes with a file size limitation of at least 20MB. How do other healthcare agencies accomplish this? The agency routinely must fax medical records requests which may be 250+ pages.
Make1tFunny@reddit
thanks for the advice
jlipschitz@reddit
Go with encrypted emails instead of faxing. Faxing is less secure if it ends up on a shared machine than an encrypted email that requires authentication to access it.
Faxing is ancient tech that needs to die!
rufus_xavier_sr@reddit
No choice with HIPAA. Thanks to octogenarian clueless congress that faxing is still the greatest thing ever. Places like the coroner will only accept a fax. Luckily many hospitals are finally sending encrypted emails.
oxidizingremnant@reddit
Ironically it's usually electronic medical record sending faxes to computerized fax machines that do OCR and use an API to ingest data into another EMR.
countsachot@reddit
The only industry I know still using modems on servers...
severach@reddit
I'm t.38 to fiber. All digital. No analog beeeeeep on my end.
Beep style pots lines are transitioning to SIP back end. I tried a few and they are terribly unreliable.
Frothyleet@reddit
The new HIPAA security rule that was originally going to be going into effect this year (before the industry pushback + admin change tabled it) would have removed the security exclusion built around faxes that existed solely because when the original rule came around the industry basically would have imploded if security rules applied to faxingl
BrentNewland@reddit
Here's the list of fax services I just went through while looking for one for our org. Some of them are HIPAA compliant.
insufficient_funds@reddit
Man that’s a heck of a list, I’m surprised I don’t see the system my org uses- Biscom Faxcom. We have something like 96 lines for in/out faxing in it, clustered-ish solution with backups at another location. I don’t know the ins and outs as I rarely touch it.
BrentNewland@reddit
I only researched online fax services, not self hosted, as we do not have physical phone lines.
insufficient_funds@reddit
Ah makes sense. If we were starting without anything we would likely do that as well; but we’ve had these lines for probably 30 years; and it just works so well and easily that we’ve never been interested in changing.
BrentNewland@reddit
All of our phone lines were moved to Teams a few years ago, before I started. I guess it was included in our level 5 Microsoft licenses. Unfortunately, I.T. never did anything with the fax line, so it just hasn't worked for who knows how long.
It's a real shame, especially when I found out Zoom's phone service includes fax and SMS on every line.
StyleSignificant1203@reddit
I'd recommend taking a look at documo also. That's what we use - they are HIPAA compliant, have a great UI, and are very reliable. They also recently released intelligent document processing which reads, extracts, and classifies documents and can patient match records in the EHR.
BWMerlin@reddit
We use gofax.
siedenburg2@reddit
Best would probably be a selfhosted faxserver like OMS9 from ferrari electronic (german company) but you need a way to connect you number/phone server to that.
kg7qin@reddit
At a previous employer we had an Faxcore server setup and FoIP served by Etherfax.
It worked good.
ButterSnatcher@reddit
We used SRFax for our hippa compliant needing customers.
no_your_other_right@reddit
We still use fax a lot between communicating with the IRS and receiving records from various medical offices. We host a fax server on prem using NetSatisfaxion software and a very inexpensive SIP trunk from AWS. Users send faxes by sending an email with pdf or docx attachments to tendigitnumber@fax.domain.com. Incoming faxes are also routed via email.
thelug_1@reddit
RightFax
SynAckPooPoo@reddit
Rightfax is very popular with healthcare customers.
madlyalive@reddit
I used Faxage a few years ago. Never had an issue.
HDClown@reddit
eGoldFax another big name that is HIPAA Compliant.
GardenWeasel67@reddit
RightFax
Vesalii@reddit
I'm sorry but who the fuck still uses fax? I've had an email address since the early 2000s. I've never faxed in my life. I've seen a machine receive a fax once or twice and it was just spam.
In this day of email, OneDrive, Teams, Mega, etc... Why...
yamsyamsya@reddit
medical practices use it all day long
theoriginalharbinger@reddit
Other countries and other industries, mostly.
Want to do business with Japanese entities? You need a fax.
Have a hard business requirement for a human-authored signature? You need a fax.
Working with an industry that mandates paper recordkeeping on all sides of an equation? You're probably going to need a fax.
And before you tell me "But why don't they change?" If you as a business - and keep in mind, IT exists to serve the business - decide "Hey, it's okay to use old tech to be able to do 10MM in revenue in Japan", then you as the IT person have to figure out how to make the fax as secure as possible.
Frothyleet@reddit
I think mean, "have a hard business requirement for a human-authored signature that inexplicably incorporates a facsimile transmission into its definition of a wet signature"
Expensive_Plant_9530@reddit
Honestly, this is such an unhelpful comment.
Who cares whether you’ve ever used fax before? In some industries, faxing is still a core business functionality. It’s not OPs fault they need to support 200+ page faxes. But they do.
I’ve had an email address since 1999. So what? That doesn’t prove anything.
H2OZdrone@reddit
We have both a cloud and on prem solution (HIPAA). We shell out somewhere around 30k a month between the 2 not including the “soft costs” of after hours patching, server maintenance, etc.
Trying to move everything to the cloud solution only but we have some automation that everyone is afraid to touch.
sryan2k1@reddit
We use Concord Fax
bshow80@reddit
I'll second Concord. It's UI might not look fantastic but it works flawlessly and has every feature I've ever needed.
MutiaraNaga@reddit (OP)
Thanks, just scheduled a demo.
StyleSignificant1203@reddit
We ran into the same issue and moved to Documo. The limits you’re hitting are pretty typical for VoIP/legacy fax. With Documo, those constraints basically go away. For example, their web portal supports up to 500MB per fax (and up to 100MB per file), so sending 250+ page medical records isn’t an issue. i would highly recommend making the switch.
Nakenochny@reddit
We use FaxBack, might be worth a look.
Fit_Prize_3245@reddit
Fax solution? Don't you prefer a telegraph one?
Nakenochny@reddit
Welcome to highly regulated industry, using antiquated solutions since the Stone Age!
Banking and accounting are also this way. Last I knew IRS still preferred fax.
MutiaraNaga@reddit (OP)
We're trying to jam 300 hotdogs down the POTs lines
WestFax_Official@reddit
WestFax routinely handles massive files, thousand page faxes aren’t unusual for us. There aren’t hard page or file limits on our side. The only real constraint is the receiving system.
Where most providers struggle is reliability on long transmissions. Fax is extremely intolerant of jitter, packet loss, and timing issues, so once you get into 100+ pages, weak networks start to fall apart.
That’s the part we’ve spent years engineering around.
Our transport network is built specifically for real-world delivery:
- Adaptive transport (we use both SIP and TDM, not just one)
- Intelligent routing across multiple carrier paths
- Smart retry logic (not just “try again,” but adjusting how it retries)
- Tuned transmission behavior (baud rate, error correction, session timing)
- Direct carrier interconnects (achievable by our scale)
We’ve processed tens of billions of fax transactions and use that data to optimize how each fax is delivered. The result is much higher success rates, especially on large sends.
That said, we don’t control the destination. Fax is kind of like a low-to-the-ground sports car; we’ve paved the smoothest possible road to get it there, but the last stretch is the recipient’s driveway. If their system is outdated, misconfigured, or has strict limits, things can still break down.
If the receiving side can handle it, 250+ page faxes shouldn’t be an issue.
gonewild9676@reddit
You probably need to use Etherfax as the backbone. The last I heard them and Rightfax were in a major pissing match with each other. Rightfax's backbone at least used to be terrible.
anonymousITCoward@reddit
We use RightFax at our high volume clinic... largest fax to date, successful was 322 pages... it ate dirt at a 500+ page fax, the sender ended up breaking that down in to 4 different sends.
MutiaraNaga@reddit (OP)
I think part of my solution needs to be resetting expectations. Failures are common above 100-150 pages due to QoS.
anonymousITCoward@reddit
That clinic gets 200+ page faxes about once a month, normally they're about 50. The QoS was one of the issues, but the other is... it's 300+ page fax... that's being converted to a PDF... you need a server that can handle that... and a dedicated circuit helps too
jstar77@reddit
We use SR Fax and have been pretty happy with it.