Verdict · Verified 18 August 2026
Fax.Plus — a clean, well-priced service with one tier-gating catch
From $6.99/mo — HIPAA/BAA on Enterprise ($79.99/mo)
As an online fax service it does the job without fuss — send from a browser, phone or API, receive to an inbox, keep a searchable record with real transmission confirmations. The catch worth knowing before you commit: HIPAA compliance and the BAA are on the Enterprise plan only, at $79.99/month. Every tier below it is unsuitable for PHI regardless of how good the encryption is. Budget for that rather than discovering it at contract review.
Try Fax.Plus free Opens on the vendor’s site · CASRAI referral link
Read the HIPAA explainer before choosing a tier → — A surprising amount of research faxing carries no PHI at all — Basic at $6.99/month covers that comfortably.
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In summary
- Free (10 pages total), Basic $6.99/mo (200 pages), Premium $13.99/mo (500), Business $27.99/mo (1,000), Enterprise $79.99/mo (4,000). Verified 18 August 2026.
- HIPAA compliance with a signed BAA is Enterprise-only. No lower tier is suitable for protected health information.
- Annual billing saves around 22% — the vendor describes it as up to three months free.
- Business and Enterprise include two fax numbers; Basic and Premium include one; Free includes none.
- The real advantage over a machine is not cost — it is per-user access logs and no paper sitting in a corridor tray.
Every Fax.Plus plan
Verified from the vendor pricing page, 18 August 2026
| Dimension | Free | Basic | Premium | Business | Enterprise |
|---|---|---|---|---|---|
| Price / month | $0 | $6.99 | $13.99 | $27.99 | $79.99 |
| Price / year | — | $83.99 | $167.99 | $335.99 | $959.99 |
| Pages | 10 total | 200/mo | 500/mo | 1,000/mo | 4,000/mo |
| Fax numbers | None | 1 | 1 | 2 free | 2 free |
| HIPAA + BAA | No | No | No | No | Yes |
| Suitable for PHI | No | No | No | No | Yes |
Pages beyond the included allowance are charged per page. Additional fax numbers are available on the paid tiers.
What you actually get
Fax.Plus, from Alohi, is cloud fax: you send from a web browser, a mobile app or an API, and you receive into an inbox rather than onto paper. There is no machine, no dedicated phone line and no toner. Documents are uploaded as PDFs or images, and you get a transmission confirmation you can keep as evidence.
For a study team the practical differences from a departmental fax machine are more significant than they sound. You get per-user accounts rather than an anonymous shared device, which means the access record identifies a person. You get a searchable history instead of a drawer of thermal confirmation slips. And nothing sits in an output tray in a corridor waiting to be collected — which, as we cover in the HIPAA fax guide, is where most real fax incidents actually happen.
What it does not do is change the fact that your counterparties still use fax. That is the whole reason this category exists in clinical research, and no software fixes it.
Choosing a tier honestly
Work out first whether your faxing carries protected health information, because that single question decides between a $6.99 plan and a $79.99 one.
If it does — participant records, source-document requests to a hospital records department, lab requisitions and results, imaging orders, signed consent forms, adverse event narratives with identifiable detail — you need Enterprise. Nothing below it includes the Business Associate Agreement, and without a BAA the transmission is not compliant however well encrypted it is.
If it does not — IRB correspondence referencing a protocol number rather than a participant, site contract and budget paperwork, vendor forms, regulatory binder administration, investigator CVs and disclosure forms, delegation logs — then Basic at $6.99/month or Premium at $13.99/month is entirely adequate and there is no reason to overspend.
One caution that decides more cases than it should: if a single account will be used for both categories, and in practice it will be because nobody maintains two separate fax habits, treat the whole account as needing the BAA. Splitting by intention rather than by account is how breaches happen.
On volume, count real pages rather than real faxes. A records request with attachments can run to dozens of pages, and page allowances are consumed faster than teams expect. Overage is charged per page, so a plan that looks generous on fax count can be tight on pages.
Strengths and trade-offs
What it does well. The pricing is transparent and the tiers are sensibly spaced. The free tier is a genuine trial rather than a demo — ten pages is enough to confirm that your actual counterparties’ fax numbers work, which is the only thing worth testing before committing. Multi-user support and an API mean it fits a team rather than one coordinator. And annual billing at roughly 22% off is a real saving on a service you will keep for the life of a study.
The trade-offs. The HIPAA gating is the significant one, and the jump from $27.99 to $79.99 is steep if all you needed was the BAA rather than 4,000 pages. Page allowances rather than unlimited sending means someone has to watch consumption during a busy month. And as with any cloud fax service, you are now dependent on a vendor’s uptime for a channel that a hospital records department may treat as your only route in — worth knowing rather than worth avoiding.
One thing worth saying plainly: no online fax service, this one included, makes fax a good technology. It remains a channel your counterparties impose on you. The value here is in removing the paper and the shared machine from your end of it, not in making the underlying protocol better.
Setting it up for a study
- Get the BAA executed before the first PHI transmission if you are on Enterprise, and file it in the regulatory binder or eTMF where a monitor can find it without asking.
- Use named accounts, never a shared login. The access log is only useful as evidence if it identifies a person, and a shared password removes the main advantage you just paid for.
- Add fax offboarding to your study close-out checklist. Coordinators roll off studies constantly and a stale account with live inbound access is an audit finding waiting to happen.
- Decide where received faxes are stored — eTMF, secure shared drive, EDC upload — and write it into the operations manual. The common failure is downloading an inbound fax to a laptop desktop.
- Verify numbers before sending and use a cover sheet with a misdirection notice. Misdial is still the most common fax incident by a wide margin.
- Test your actual counterparties on the free tier first. Some hospital fax gateways are fussy; better to find out over ten free pages than after a purchase order.
Test your counterparties on the free tier
Ten free pages is enough to confirm that the hospital records departments and referring practices you actually deal with accept transmissions from the service. That is the only question worth answering before you choose a tier.
From $6.99/mo — HIPAA/BAA on Enterprise ($79.99/mo)
Try Fax.Plus free Opens on the vendor’s site · CASRAI referral link
Frequently asked questions
How much does Fax.Plus cost?
Free for 10 pages total, Basic $6.99/month for 200 pages, Premium $13.99/month for 500, Business $27.99/month for 1,000, and Enterprise $79.99/month for 4,000 pages. Annual billing saves around 22%. Verified 18 August 2026.
Is Fax.Plus HIPAA compliant?
On the Enterprise plan only, which includes HIPAA compliance with a signed Business Associate Agreement at $79.99/month or $959.99/year. The Free, Basic, Premium and Business tiers do not include the BAA and are not suitable for protected health information.
Can I use the cheap plan and just be careful?
No. HIPAA requires a Business Associate Agreement whenever a third party transmits PHI on your behalf, and care on your part does not substitute for it. If any of your faxing carries PHI, and especially if one account handles both PHI and admin traffic, you need the Enterprise tier.
Do I need a fax machine or phone line?
No. Fax.Plus sends from a browser, mobile app or API and receives into an inbox. That is most of its practical value for study teams — it removes the shared machine and the paper output tray, which is where the majority of real fax confidentiality incidents occur.
How many pages will a study team use?
More than expected — count pages rather than faxes. A single source-document request with attachments can run to dozens of pages, and overage is charged per page. A plan that looks generous on fax count can be tight on pages during an active recruitment period.
Is an online fax service better than a fax machine?
For confidentiality and record-keeping, yes. You get per-user accounts instead of an anonymous shared device, a searchable transmission history instead of thermal confirmation slips, and no paper waiting in a corridor tray. It does not make fax a good technology — it just removes the worst part of your end of it.
