Best HIPAA fax for a small medical practice, from $4.99 with a BAA

A small medical practice of 3 people at 200 pages a month pays $4.99 a month billed annually on Fax Pigeon Basic, with a signed BAA and its own number, against $10.70 at SRFax, $33.33 at eFax Business and $39.95 month to month at WestFax Team; at 1,000 pages Fax Pigeon Plus is $16.99 against $54.16 at eFax.

Which online fax service should a small medical practice use?

A small medical practice should use an online fax service that signs a BAA on the plan it buys, gives the office its own number and lets the whole staff share it, three things every Fax Pigeon plan does from $4.99 a month billed annually for 200 pages. HHS's cloud computing guidance says a covered entity that uses a cloud service to process or store electronic PHI without a BAA is in violation of the HIPAA Rules. HHS also says it certifies no product as HIPAA compliant, so a HIPAA label is the vendor's own claim.

45 CFR 164.502(e)(2) requires the business associate's assurances in a written agreement that meets 164.504(e), and that agreement is the BAA. Fax Pigeon signs it at sign-up on every plan, and the text is public at faxpigeon.com/baa before paying. Fax Pigeon has no team plans: every plan includes unlimited people. More on how to choose a HIPAA fax service.

What do small medical practices fax, and to whom?

Small medical practices fax referrals and consult requests to specialists, prior authorization requests to health plans and prescriptions to pharmacies, and they receive lab results and outside records in return. Under 45 CFR 160.103, a fax counts as an electronic transmission unless the information did not exist in electronic form immediately before it was sent, so a fax sent from a computer file is electronic.

The table shows what a small medical office faxes, where it goes and the rule behind it.

HHS says a provider sending records for treatment needs no BAA with the provider who receives them. CMS says the prior authorization decision deadlines in its interoperability rule apply whether a request arrives by API, portal, fax or phone. HHS calls it a reasonable safeguard to confirm a number with the recipient when it is not regularly used, and state law generally sets how long faxed records that belong in the chart are kept.

What does HIPAA fax cost a small office at 200 and 1,000 pages?

A 3-person medical office pays Fax Pigeon $4.99 a month billed annually for 200 pages and $16.99 for 1,000, with a signed BAA, where SRFax charges $10.70 and $29.50 and eFax Business $33.33 and $54.16. Every Fax Pigeon plan counts pages sent and received together, and an extra page costs 10 cents on Basic and 5 cents on Standard.

For a 3-person medical office, the table matches every provider's lowest-priced BAA plan to its price a month at 200 and at 1,000 pages sent and received.

At 1,000 pages, a year on Fax Pigeon Plus costs $203.88, which is $150.12 less than SRFax and $446.04 less than eFax Business, each billed annually.

At five people, the table repeats the comparison for each provider's cheapest plan with a BAA, priced a month at 200 and 1,000 pages sent and received.

Only iFax moves between 3 and 5 people, from $66.65 to $93.29 a month billed annually and from $79.97 to $111.95 month to month, because each person past the first needs an iFax team license on Pro.

Which costs do not show on the price card?

The costs a price card leaves off are how the BAA is signed, what each added user and number costs, how pages past the plan are billed and what it costs to port a number in.

The table shows the full cost stack for each provider, from each provider's own pages.

On certain plans, eFax's Customer Agreement charges the Usage Prepay Amount to the card "without further authorization" once usage passes the plan's pages, and counts pages by full and partial 60-second increments of transmission or connection time when that number is greater. Under iFax's Terms of Use, credits are added automatically once usage reaches "95% of your plan limit", and a page that takes over a minute uses credits by its average duration. Fax Pigeon bills extra pages on a separate invoice, at renewal on a monthly plan or every 30 days on an annual one.

SRFax warns that some providers purge faxes when a number ports out, and a BAA must require the vendor to return or destroy PHI at the end of the contract, where feasible, under 45 CFR 164.504(e)(2)(ii)(J).

Does eFax sign a BAA on its cheaper plan?

eFax's cheaper Personal plan carries no BAA, and eFax's HIPAA page names only eFax Business, eFax Corporate and eFax Unite as covered, so a small practice's first eFax plan with a BAA is Business, at $33.33 a month billed annually. The pricing page puts HIPAA-compliant encryption on every plan and names Business as the plan that "includes the signed BAA".

eFax's Customer Agreement confines the BAA to its Secured Service, covering eFax Business, eFax Protect or eFax Unite, while no other eFax service may hold the customer's protected health information. Protect lives on in that addendum's heading and in a login label; the pricing page shows no Protect plan or price. eFax may amend its BAA by notice or by posting a new one, so a practice keeps a dated copy.

Can the whole office share one number and inbox?

A whole medical office can share one Fax Pigeon number and one inbox, with roles and assignment, and adding people costs nothing on any plan. HIPAA's Security Rule makes unique user identification a required specification under 45 CFR 164.312(a)(2)(i), so staff who share a number still sign in as themselves.

WestFax licenses are named logins: Solo includes 1, and Team includes 5 or 25 by tier. Doximity's DocFax page offers its line to U.S. licensed physicians, nurse practitioners, physician assistants and pharmacists, which makes it one clinician's number. More on whether Doximity fax is HIPAA compliant and on HIPAA fax with unlimited users.

Which practices should switch, and to what?

A small medical practice should switch to Fax Pigeon when it pays per user, holds a plan whose HIPAA label carries no BAA, or pays more than $4.99 a month for 200 pages or $16.99 for 1,000 pages with a BAA. That covers primary care and family medicine, pediatrics, urgent care clinics, nurse practitioner practices and small specialty clinics. Fax Pigeon serves medical offices of any size, from a solo practice to a team of 100 or more.

Moving the office's number to Fax Pigeon is free on every paid plan, and the current provider keeps receiving on it until the transfer finishes. SRFax quotes approximately 10 to 15 business days for a port in, and eFax requires written notice no later than 30 days after an account ends to port out a number that was ported in. One person's prices at 200 and 500 pages are compared in what a HIPAA fax with a signed BAA costs one person.

* 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.