Tossing the Fax Machine and Embracing Modern Faxing

By Matthew Larson, DDS, MS

Matt LarsonIn the modern world, hearing the dial up noise of a fax machine represents a technological step back in time.  However, the widespread use of faxing will likely continue for the following reasons:

  • Universal Acceptance:  Faxing is almost universally accepted by insurance companies and dental offices, while some do not accept emails.  These fax numbers are also typically easier to locate in business directories.
  • Security:  Due to the point-to-point nature of fax protocol, attempts to intercept data will typically cause the transmission to fail.  Therefore, faxing is generally considered secure and meets HIPAA requirements for electronic transfer of data.
  • Legally Binding:  The receiving machine must properly acknowledge that a fax was successful.  This means that the message can legally be considered received, which is different than most other forms of electronic communication, such as email.

These benefits mean that the capability to fax is still important in the modern orthodontic office, but it does not necessarily mean a fax machine is needed.  Fax machines function well, but requires a modest initial cost ($45 to $200+) and the ongoing expense of an additional phone line (~$20/month).  Although it is possible to avoid an additional line by attaching a switch to an existing voice line or using a dual ring, these methods are not as consistent as a dedicated line.  This option is straightforward, but are there better modern options?

Yes!  Moving from traditional faxing to IP faxing (also known as internet faxing or FoIP – Fax over Internet Protocol) offers numerous benefits and less cost!  It allows an orthodontic office to remove the extra phone line, get rid of a fax machine, and still utilize all the previously mentioned benefits of faxing.  The switch to IP faxing has occurred slowly because previous IP faxing protocols did not interact well with traditional fax lines.  However, modern protocols (T.37 for store-and-forwarding or internet faxing, and T.38 for real-time faxing) have greatly improved reliability.  Options for moving to IP faxing include purchasing software for a computer or a VoIP server, buying a FoIP/VoIP server, buying an IP fax machine, or using a 3rd party online provider.  All these options have certain advantages, but purchasing any equipment or software for the office will incur higher up-front costs and may need ongoing service.

Personally, I feel that most orthodontic offices should consider internet faxing using an online provider.  This keeps startup costs low and requires no additional equipment (assuming you already have a computer and internet access).  There are a large number of companies to choose between, so I would suggest looking into HIPAA-complaint companies with positive reviews that offer a good price for the volume of faxes sent by your office.  Some providers even allow a small amount of online faxing for free (e.g. eFax, faxzero), but some of these accounts may be disabled after 30 days of inactivity.  Our office currently maintains a plan for $3.49/month and $0.05 per minute of faxing (Faxage), and our monthly bill has never exceeded $6.00 – much less than the cost of a phone line.   For a slightly higher base fee ($6.59/month), some companies offer integration with Dropbox, Outlook, and Google Drive (e.g. Ring Central).  Overall, these online services typically offer the following advantages:

  • An online portal where all incoming and outgoing faxes are stored.
  • Faxing using traditional email with an attachment.  (NOTE: this is sent securely from the online service, but will have the limitations of email while being emailed to the service).  A receipt is emailed back when the fax is successfully sent.
  • The ability to directly save the file to the computer and upload into practice management software without printing, keeping the practice paperless!
  • Higher quality images than traditional faxes with the ability to print on any desired printer at your office.
  • The ability to use multiple workstations to send and receive faxes.

There are two potential downsides to consider when switching to IP faxing.  First, it is very easy to create a fax number, but it may take more work to maintain a current number.  Second, these services typically provide T.37 store-and-forwarding faxing – meaning they hold the fax in a queue and it may take 1-2 hours to send.   If these concerns are not issues for your practice, consider looking into IP faxing to inexpensively and conveniently handle your faxing needs.

5 thoughts on “Tossing the Fax Machine and Embracing Modern Faxing”

  1. I was told I needed to offer alternatives to the fax and ideas for future blogs so here goes….

    As to faxing:
    Why not try Turboscan or DocuSign or any similar program that you can use on a smart phone instead of paying to fax electronically or otherwise??

    As to ideas for future blogs, here are a couple:
    1) What does the industry need to do to demand our practice management software start managing more than our patients (HR, Financials, inventory, purchasing) 2) utilizing advanced phone systems to reduce front desk employees and customer service 3) using thin client computers or services such as share point to reduce the number of PCs needed in office. 4) reducing imaging time

  2. This topic was chosen for 2 reasons. First, there are still a large number of orthodontic practices that maintain an active fax machine. For these offices, internet faxing can easily save a few hundred dollars per year in overhead, declutter the office, and save staff time. Second, many offices have completely abandoned faxing, yet it remains the most widely accepted method of electronic transfer that is legally considered HIPAA-compliant and secure. When I opened my practice, I personally tried to avoid faxing. However, my attorney, insurance company, and bank all will not accept electronic signatures and documents either need to be sent by certified mail or fax. Also, I still have a couple referring offices that prefer fax. Although I could get by without faxing capability, it simplifies communication enough for my office to be worth the $5/month. I am not advocating that it should be a primary form of communication and I acknowledge that its use is decreasing, but it is not likely to fully phase out of use for years in many areas (including mine).

    In regards to the suggested mobile apps, I use both DocuSign and CamScanner (which is basically Turboscan) on a regular basis. However, CamScanner or Turboscan are apps for scanning, not secure electronic communication. They integrate with email and are very useful, but some companies will not accept email for certain communications. Just last month, I received documents for my 401k plan right before I was leaving town which either had to be mailed back or faxed. We immediately left town – I reviewed the documents, signed them, scanned them with CamScanner, and faxed them from my phone while my wife was driving.

    DocuSign is VERY interesting for electronic signing, since it can host encrypted documents on the cloud for signing. This type of technology absolutely will replace faxing, but it still lacks the widespread participation (a quick google search estimated 150 million signatures have been sent through DocuSign, compared to nearly 17 billion faxes sent each year). There are also other options for secure communications (e.g. SFTP, SSH, HTTPS, VPN, SCP) and many of them are much better than faxing in terms of security and speed, but until the professional and insurance offices that I work with adopt a better standard method of electronic communication, maintaining a simple, modern (cloud and mobile integration), and cheap method to fax remains useful in my practice.

  3. Hello Matthew,
    Thanks for such an informative post.
    You have clearly outlined each and every point.
    Worth going through it. I enjoyed reading it.
    I like Internet faxing though it has some disadvantage but it is far better, faster, secure reliable, time saving and cost effective.

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