How to send a HIPAA fax without a landline or a fax machine

A practice can send and receive HIPAA-compliant faxes with no landline and no fax machine: an online fax service that signs a BAA gives it a fax number of its own and sends from a browser or by email, and Fax Pigeon does this from $4.99 a month billed annually with the BAA on every plan.

Can you fax without a landline or a fax machine?

A practice can fax without a landline or a fax machine by using an online fax service, which sends and receives faxes over the internet. AT&T Business describes the route in its guide to faxing without a phone line: documents go up through a web portal or by email, and the service delivers them as faxes.

The route fits a telehealth-only practice, a home office, an office whose copper line is being retired and an office moving off a fax machine. The FCC's revised network change disclosure and service discontinuance rules (FCC 26-19) took effect on October 15, 2026, according to the Federal Register notice of October 1, 2026 (91 FR 62334). What that means for a fax number is in what happens to your fax number when the copper line goes.

What are the ways to fax without a phone line?

The ways to fax without a phone line are an online fax service in a browser, email to fax through that service, a free fax website and a fax machine kept on internet phone service, and the first two come with a signed BAA.

For each way to fax without a phone line, the table gives what it needs and whether it suits patient documents.

The machine route keeps the hardware. A business VoIP provider's help center lists the adapter and the extra number it needs, and carrier Bandwidth's T.38 support guide says calls typically cross several carriers, so a T.38 fax becomes vulnerable unless every carrier in the call flow supports T.38. A digital copier that faxes also keeps copies: the FTC says the hard drive in a digital copier stores data about the documents it copies, prints, scans, faxes or emails.

The browser route takes more file types than the email route. In Fax Pigeon's browser, PDFs, Word, Excel and PowerPoint files and phone photos upload unchanged, and a cover sheet is optional; email to fax takes one PDF. The full comparison of the two setups is in online fax vs a fax machine.

How do you receive faxes without a phone line?

Faxes arrive without a phone line when the fax number belongs to the online fax service: a fax sent to that number lands in the account's inbox, readable in a browser.

At Fax Pigeon, paid plans send and receive from the practice's own number. Everyone in the practice shares one number, one inbox and one page allowance, adding people costs nothing, and the shared inbox has roles and assignment. Every plan adds AI summaries, e-signatures and delivery proof for every delivered fax.

Pages count sent plus received: Basic is $4.99 a month billed annually, or $5.99 month to month, for 200 pages, and Standard is $9.99, or $11.99, for 500. Sending can begin before a plan: one fax of up to 10 pages goes out from a shared number once an email is confirmed, with no credit card and under the same signed BAA, while receiving takes a paid plan.

What does HIPAA require once the fax leaves the machine?

Once the fax leaves the machine, HIPAA requires a signed BAA with the online service that holds the faxes, because HHS treats a cloud service that maintains ePHI as a business associate even if it stores only encrypted faxes and cannot read them.

The conduit exception is narrow. HHS's cloud computing guidance limits it to transmission-only services, including temporary storage incident to the transmission, and holds a covered entity in violation of the HIPAA Rules when a cloud provider maintains its ePHI without a BAA. HHS's audio-only telehealth guidance draws the same line for phones: no BAA with a telecom provider that only connects the call, and a BAA with a vendor that is more than a mere conduit.

Moving off paper also moves the fax into the Security Rule. 45 CFR 160.103 excludes a fax from electronic media only when the information did not exist in electronic form immediately before it was sent, and the 2003 Security Rule preamble says paper-to-paper faxes are outside that rule for the same reason. A fax that starts as a file on a computer is inside it, and the Privacy Rule covers a paper fax as well. HHS says a practice sending ePHI over the internet must assess its use of open networks, choose a way to protect the transmission and document the decision.

HHS gives confirming a rarely used fax number with the recipient as an example of a reasonable safeguard, and pre-programming frequently used numbers as another. Every fax must also carry the date and time it is sent, the sender's identification and the sending number, under 47 CFR 68.318(d). HHS adds that its Office for Civil Rights "does not endorse, certify, or recommend specific technology or products," so the signed BAA is the document a practice keeps.

How do you keep your fax number when the landline goes?

A practice keeps its fax number when the landline goes by porting it to the online fax service before the line is canceled, and under FCC rules a carrier has one business day to complete a simple port.

Under 47 CFR 52.35, the one-business-day limit covers simple ports and a four-business-day limit covers non-simple ones, counted Monday through Friday, and either runs longer only when the new provider or the customer asks. A simple port order starts with the ported number, the account number and the ZIP code, under 47 CFR 52.36. The FCC's porting guide adds that the old company cannot refuse the port over an unpaid balance or termination fee, and that some rural wireline providers may obtain state waivers, so their customers may be unable to port.

Fax Pigeon charges nothing for the port on any paid plan, and it starts at sign-up or from Settings; the landline keeps receiving faxes on the number until the port completes, and most transfers need 5 to 15 business days. The steps, in order, are in porting a fax number before you cancel.

How do you set it up, step by step?

Setting up fax without a landline takes six steps, and the old line stays open until the number has moved.

1. Sign up with an online fax service that signs a BAA, in a web browser.
2. Sign the BAA; at Fax Pigeon it is part of sign-up, and the full text is at faxpigeon.com/baa.
3. Start the port of the current fax number with the new service, or choose a new number.
4. Keep the landline account open until the port completes.
5. Send from the browser, or email one PDF from the account's address.
6. Cancel the landline once faxes arrive at the number in the new account.

* Fax Pigeon prices and plan terms as of October 20, 2026. Outside sources were read on October 19, 2026.