HIPAA compliant fax for acupuncturists and naturopaths

An acupuncture or naturopathic practice becomes a HIPAA covered entity by what it sends: a standard transaction, such as a claim to a health plan, in electronic form (45 CFR 160.103). Fax Pigeon includes a signed BAA on every plan, from $4.99 a month billed annually, whichever side of that test a practice is on.

HHS requires a covered entity to have a written BAA with a vendor that stores its protected health information. An entity outside the covered-entity and business-associate definitions does not have to comply with the HIPAA Rules, HHS says.

Which transactions put an acupuncture or naturopathic practice under HIPAA?

The rule sorts providers by what they send. A provider is a covered entity if it "transmits any health information in electronic form in connection with a transaction covered by this subchapter" (45 CFR 160.103). The CMS Covered Entity Decision Tool turns that into two questions. Does the practice furnish, bill or get paid for health care in the normal course of business? Does it send any covered transactions electronically? Two yeses make a covered entity. The first question is broad, because section 160.103 defines health care as care, services or supplies related to the health of an individual.

Covered transactions are the ones HHS has adopted standards for, in 45 CFR Part 162. For a provider they include claims to a health plan, eligibility inquiries, claim status inquiries and requests for authorization. A provider whose clearinghouse sends them on its behalf counts as sending them, the CMS tool says.

The payer is part of the test. A standard claim is a request for payment sent to a health plan (45 CFR 162.1101), and HHS says long and short term disability, workers' compensation and automobile liability policies are not health plans. HHS's list of example providers, which runs from doctors and clinics to chiropractors and pharmacies, carries the same condition: each is covered only if it sends those transactions electronically. Each practice answers the second question for itself.

What arrives by fax on either side of the test?

Physician referrals. In ONC's 2019 survey, 35% of office-based physicians used only fax, mail or e-fax to share patient health information with providers outside their organization (ONC Data Brief No. 59). The wider case is in Why do doctors still use fax? HIPAA lets a covered physician disclose a patient's information for another provider's treatment (45 CFR 164.506(c)(2)), and HHS says the referring office needs no BAA with the provider it sends a chart to (HHS guidance). A referral can reach a practice on either side.

Workers' compensation. Oregon's Workers' Compensation Division, for one, gives an acupuncturist who treats on an attending physician's referral seven days from the start of treatment to send the insurer and the prescribing provider a treatment plan. Its tip is to fax the plan and keep the confirmation page in the worker's file. If no plan reaches the insurer in seven days, the insurer is not required to pay. An insurer's request for reports must be answered within 14 days (acupuncturist handbook). A naturopathic physician who is the attending physician signs that plan and sends it to the insurer within 30 days, with the same fax tip (naturopathic handbook). Every delivered fax gets a Fax Pigeon delivery certificate, a record to file where Oregon says to keep the confirmation page.

Does a fax service need to sign a BAA?

HHS names a cloud service provider that processes or stores electronic PHI for a covered entity as a business associate, and the covered entity needs a written contract with it (45 CFR 164.502(e) and 164.308(b)). HHS limits the conduit exception to services that only transmit PHI, temporary storage included. An online fax service whose inbox keeps a practice's faxes is storing them for the practice.

For a practice outside both definitions, a BAA is optional under HIPAA. Every Fax Pigeon plan includes a signed BAA, executed at signup, so taking the option adds nothing to the price. The first fax is free too: one fax of up to 10 pages, no credit card, under the same signed BAA.

Can an acupuncturist or naturopath use Doximity's free fax?

Doximity's DocFax page offers its free fax to U.S. licensed physicians, nurse practitioners, physician assistants and pharmacists. It names neither acupuncturists nor naturopaths. A practice off that list needs another service, and Is Doximity fax HIPAA compliant? covers what the free line allows.

What does a fax service with a BAA cost for 200 or 500 pages?

Plans that carry a BAA, grouped by the pages they cover:

eFax's pricing page says its Business plan "includes the signed BAA"; its Personal card (200 pages, $15.83 billed annually, $18.99 month to month) says HIPAA Compliant and lists no BAA. Fax.Plus offers the BAA on its Enterprise plan only, which starts at $79.99 a month billed annually ($99.99 month to month) for 4,000 pages. The BAA price comparison goes plan by plan.

Every Fax Pigeon plan has every feature, and for a practice that takes referrals the useful ones are the signed BAA, a dedicated number and a shared inbox with roles and assignment. Pages are sent and received combined, extra pages cost 10¢ on Basic and 5¢ on Standard, and faxes keep arriving past the page budget. A practice that sends and receives 8 faxes a week at 5 pages each moves about 173 pages in a month, inside Basic's 200. The pricing page lists all six plans.

Who should switch?

Switch if the practice faxes from a machine and wants its referrals in a browser inbox, if its fax service lists the BAA only on a plan above the one it pays for, or if a colleague pointed it to a free physician fax line it is not eligible for. Porting in costs nothing on a paid plan, most numbers move in 5 to 15 business days with the old line receiving meanwhile, and the steps for porting a number before you cancel have the order.

* Prices last verified October 7, 2026, at each provider's own site. Fax Pigeon is not affiliated with SRFax, WestFax, eFax, Fax.Plus or Doximity.