Why does healthcare still use fax?

Because the receiving side accepts it. Payers process prior authorizations by fax, government agencies take evidence and applications by fax, courts accept fax filings, and electronic health record systems from different vendors still cannot exchange a document reliably. Fax works between any two offices with no shared software.

Is fax being phased out in healthcare?

One slice is. A federal rule effective in 2026 with compliance required by May 2028 adopts electronic standards for claim attachments. It explicitly excludes prior authorization, and it does not touch referrals, records releases, agency filings or anything outside claims. Fax volume for those is unaffected.

How many prior authorizations does a practice handle?

The American Medical Association's 2025 survey reports physicians completing about 40 prior authorizations a week, costing roughly 13 hours of staff time a week, and 40 percent of physicians have staff who work exclusively on prior authorizations. Much of that traffic moves by fax.

What is the modern way to fax?

An online fax service: upload the PDF in a browser, send from your own number, receive inbound faxes as PDFs with a summary, keep the delivery certificate. Fax Pigeon does this with a signed BAA on every plan from $4.99 a month billed annually.

September 2, 2026

Why do doctors still use fax?

Payers, agencies and courts still accept nothing else, every EHR speaks a different dialect, and a fax leaves a record. The real reasons fax survived, the federal rule that changes one slice of it in 2028, and how a practice runs it from a browser for $4.99 a month.

A doctor holding a tablet in a hospital corridor

Doctors still fax because the other side still accepts nothing else. Payers, agencies, courts and other practices receive faxes on whatever equipment they already own, with no shared software and no account to create. The reasons are structural, they are not going away on any near timeline, and the practical answer is not a fax machine. It is a browser and a number you own.

The counterparty decides the channel

A practice does not choose to fax. The office it is sending to does. Some of the places that still take fax, and often only fax:

Payers, for prior authorizations and appeals. The AMA's 2025 survey puts the load at about 40 prior authorizations per physician per week and about 13 hours of staff time; 40 percent of physicians have staff who do nothing else. A great deal of it moves by fax, and in Texas a standard prior authorization form must by law be accepted by essentially every payer, by fax.
Federal agencies. The Department of Veterans Affairs takes claims evidence at a national intake fax line. Social Security takes medical evidence by fax behind a case-specific barcode cover sheet. The IRS takes power-of-attorney forms at fax units by region.
State systems. Motor vehicle title units, workers' compensation boards, child-support agencies that require employers to respond to withholding orders by fax, mail or portal.
Courts, where local rules allow fax filing, typically for documents under a set page count.
Other practices. A referral office, a pharmacy, a lab, a specialist. If their system and yours are from different vendors, the fax is the one channel both have.

The EHRs do not talk to each other

Electronic health records from different vendors still cannot reliably hand a document to one another. Interoperability standards exist; adoption at the level of a small practice does not. A discharge summary from a hospital to a nursing facility is still, in 2026, a 40-to-80-page fax. A referral from a primary care office to a specialist on a different system is a fax. Any practice that has tried to get records from another office by email has learned why.

A fax leaves a record

A fax has a beginning and an end: one transmission to one number, with a confirmation of the pages that arrived. That is the record a payer dispute, a records-request audit, or a court asks for. Email produces copies; a fax produces a receipt. The point-to-point property is also why HIPAA never prohibited fax; the detail is in Is online fax more secure than email?.

The rule that changes one slice in 2028

A federal rule finalized in 2026, with compliance required by May 2028, adopts electronic standards for the clinical documentation that supports a claim: the attachments. CMS describes it as phasing out fax and mail for those attachments. Two things about it matter to a practice:

It applies to claim attachments. It explicitly excludes prior authorization, which is the largest fax workflow in outpatient care.
It says nothing about referrals, records releases, agency filings, court filings, or any counterparty outside the claims process.

So the volume that most practices actually fax is untouched, and even the attachment slice runs to 2028.

What has changed: The machine

The fax machine is what went away. A practice in 2026 runs fax from a browser: upload the PDF, choose the contact, send from the practice's own number, keep the delivery certificate. Incoming faxes arrive as PDFs in an inbox, each with a summary of what it is. The number ports in from the old service and ports out again if the practice ever moves. The whole thing costs less than a phone line.

Fax Pigeon is that service, built for practices of any size:

A signed Business Associate Agreement on every plan, including the free first send, public at
Your own local number on every paid plan, porting free both ways
An AI summary of every inbound fax
E-signatures, cover sheets and contact management, so nothing is printed
A delivery certificate on every fax
Records for the life of your account, encrypted, with an audit trail
Our own fax servers on every call
From $4.99 a month billed annually for 200 pages, with unlimited people on one number and no per-seat fees on any plan

The first fax is free. Plans are on the plans section.

* Facts last verified September 2, 2026. Not legal advice.

Fax Pigeon

HIPAA-compliant fax with a signed BAA on every plan

Plans from $4.99 a month billed annually with 200 pages, your own number and unlimited people. Higher volumes from $16.99 a month with 1,000 pages; every plan is the whole product, with no per-seat fees. Every paid plan includes the BAA, free number porting, sending a fax by email from the address on your account, an AI summary of each inbound fax, e-signatures, contact management, and a delivery certificate on every fax. The first fax is free.

Know a practice that still faxes? The referral program pays 20% of the plan charges we collect from every practice that joins through your link, every month it stays.

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