HIPAA fax for chiropractors: BAA, insurer records and price

A chiropractic office needs a signed BAA, its own fax number and delivery proof for the records it sends to insurers, and for two people at 200 pages a month Fax Pigeon Basic is $4.99 a month billed annually, against $10.70 at SRFax and $33.33 at eFax Business, billed annually, and $39.95 month to month at WestFax Team.

What is a good HIPAA-compliant fax service for a chiropractic office?

A good HIPAA-compliant fax service for a chiropractic office signs a BAA on the plan the office buys, gives the office its own number and records delivery proof, and Fax Pigeon does all three from $4.99 a month billed annually for 200 pages. CMS lists chiropractors among the providers covered by HIPAA when they submit transactions such as claims electronically. HHS counts a service that stores electronic PHI as a business associate even when it never views the information, and 45 CFR 164.502(e) requires a written agreement with it.

Fax Pigeon signs the BAA at sign-up on every plan. Fax Pigeon has no team plans: every plan includes unlimited people, so the front desk, the doctors and billing share one number and one inbox at no added cost.

What do chiropractors fax, and to whom?

Chiropractors fax Medicare documentation to their contractor, records to auto insurers and attorneys, and referrals to physicians, and they receive imaging reports and records requests in return. ONC's Data Brief 59 found that 35% of office-based physicians used only fax, mail or e-fax in 2019 to share patient information with providers outside their organization.

The table shows what a chiropractic office faxes, who receives it and the rule that lets it go.

Florida's personal injury protection law requires a treating provider to furnish a written report of the history, condition, treatment, dates and costs when the insurer asks, bills go on a CMS 1500 form, and charges for services more than 35 days before the statement's postmark or electronic transmission date need not be paid, with stated exceptions (Fla. Stat. 627.736). A patient's own request to send records to an attorney must be in writing and signed and must clearly identify the person and where to send the copy (45 CFR 164.524(c)(3)(ii)). Section IV of the American Chiropractic Association's Code of Ethics asks doctors of chiropractic to protect confidential information except as the patient directs or the law requires.

How does a chiropractic office answer a Medicare records request by fax?

A chiropractic office answers a Medicare additional documentation request by faxing the records to its contractor's published number, with the ADR letter as the first page, within 45 calendar days, or 30 for a UPIC. CMS lists fax beside US Mail, esMD, the contractor's portal and CD, DVD or USB as the ways a contractor receives a response (CMS, additional documentation requests).

1. Note the letter's date. CMS's Program Integrity Manual gives MAC, RAC and SMRC requests 45 calendar days and UPIC requests 30, and First Coast counts the 45 days from the date of the ADR letter.
2. Put the ADR letter, or the response cover sheet the letter encloses, on top of each claim's records. First Coast asks for the letter's first page as the cover sheet, and CGS prints a QR barcode in the bottom right corner of its letter's first page that indexes the response to the pended claim.
3. Include records for all service dates on a claim, as CMS's chiropractic checklist MLN1232664 (April 2025) says, and follow the signature fact sheet MLN905364 for signatures.
4. Send one fax per claim to the contractor's number. Noridian's Jurisdiction F Part B takes prepayment review at 701-277-7852 and post-payment review at 701-277-6977, and First Coast takes responses at 904-361-0318.
5. Send by one method only. First Coast's guide says duplicate responses can prolong the review and lead to denials.

Noridian bars half sheets and double-sided paper and asks for another method when the documentation runs past 200 pages. A claim with no response is denied with remark code M127, and insufficient documentation caused 95.5% of improper payments for chiropractic services in the 2024 reporting period. Every delivered Fax Pigeon fax gets delivery proof, and Noridian's portal shows the receipt of ADRs submitted by any method. More on whether a Medicare claim can be faxed.

What does HIPAA fax cost a chiropractic office at 200 and 500 pages?

A two-person chiropractic office pays $4.99 a month billed annually for 200 pages or $9.99 for 500 on Fax Pigeon, with a signed BAA, while SRFax charges $10.70 and $13.65 and eFax Business $33.33 at either volume. An extra page costs 10 cents on Fax Pigeon Basic and 5 cents on Standard.

For a two-person office, the table gives each provider's cheapest plan with a BAA as a monthly price at 200 and 500 pages sent and received.

A second person moves WestFax from Solo, capped at one user, to Team at $39.95, and adds an iFax team license on Pro, at $49.99 a month billed annually or $59.98 month to month. Against Fax Pigeon Basic, a two-person office pays $340.08 a year more at eFax Business and $540.00 more at iFax, each billed annually.

For five people, the next table gives the monthly cost of the lowest-priced plan carrying a BAA at every provider, for 200 or 500 pages sent and received.

At five people, eFax Business still fits its 5 user licenses, and iFax reaches $1,119.48 a year at 200 pages against $59.88 for Fax Pigeon Basic.

Does chiropractic software replace a fax service?

Chiropractic software adds fax through a partner, an add-on or the membership itself, each priced on the vendor's own pages, and a separate fax service gives the office its own number beside any of them. Jane's integrated fax needs a Documo license at $15 USD a month for 500 pages, with $0.08 for each extra page, 3 numbers and 10 users. ClinicMind lists fax as an add-on from $4 a month plus $0.17 a page inbound and $0.19 outbound.

WebPT's documentation says every WebPT Membership includes outbound faxing, while Direct Secure Messaging is exclusive to Message Manager. More on whether Jane has fax.

How do physical therapy and acupuncture clinics fax the same records?

Physical therapy and acupuncture clinics fax the same kinds of records to Medicare, workers' compensation programs and Medicaid, under rules of their own. Since January 1, 2025, Medicare accepts a physician's or NPP's signed and dated order or referral in place of the signature on a therapist's initial plan of care when the record shows the plan reached the physician or NPP within 30 calendar days of the therapist's initial evaluation. Chiropractors may not certify or recertify plans of care for therapy services.

Washington's Department of Labor and Industries has physical, occupational and massage therapists fax form F245-417-000 for visits 13 to 24, and fax records to 360-902-4567 with the claim number on every page. West Virginia Medicaid prints one prior authorization fax line, 1-844-633-8431, for PT/OT, podiatry, chiropractic and other services, and its chiropractic form requires registration on Atrezzo whether a request goes by fax or electronically.

Medicare's coverage of acupuncture for chronic low back pain requires auxiliary personnel to work under a physician's, PA's or NP/CNS's supervision. More on HIPAA fax for physical therapy and HIPAA fax for acupuncturists and naturopaths.

Which chiropractic offices should switch, and to what?

A chiropractic office whose plan charges per person, puts the BAA on a higher tier or costs more for the same pages should switch to Fax Pigeon Basic, which covers 200 pages for $4.99 a month billed annually. Massage and occupational therapy clinics that fax the same records face the same choice.

Fax Pigeon ports the office's number free on every paid plan, and faxes keep reaching that number at the current provider through the 5 to 15 business days most transfers take. eFax's Customer Agreement lists a $40 fee per number to port in and a $40 administrative fee per number to port out. At two people and 500 pages billed annually, Fax Pigeon Standard costs $280.08 a year less than eFax Business and $480.00 less than iFax.

* Prices last verified October 19, 2026, at each provider's own site. Fax Pigeon is not affiliated with SRFax, eFax, iFax, Fax.Plus, WestFax or Sfax.