SIP Trunking

Portal Feature Update: Premium Fax SIP Trunk is Here!

Thoroughly tested to ensure T38 compatibility and eliminate many of the issues found with fax over SIP.

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By Michael Bratschi
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Portal feature update: Premium fax SIP trunk is here

Premium fax SIP trunk is here. We've created a custom outbound profile specifically designed for completing faxes over SIP. This outbound profile has been thoroughly tested to ensure T.38 compatibility and eliminate many of the issues found with fax over SIP. This is a premium fax trunk, and you'll notice that there is a separate fax rate deck that can be downloaded from the pricing page.

Why fax still matters for business communications

While some may consider fax outdated, it remains critical for industries requiring secure, compliant document transmission. According to Bloomberg Law, approximately 70% of healthcare organizations still rely on fax for external communications. The Office of the National Coordinator for Health Information Technology (ONC) reports that mail and fax remain the primary methods hospitals use to send and receive health information.

"The fax services market is expected to reach USD 6.5 billion by 2029, rising at a CAGR of 11.08%. Healthcare providers frequently exchange a high volume of sensitive documents, including medical records, lab results, prescriptions, referral letters, billing information, and insurance claims. This continuous need for secure and reliable communication sustains the demand for fax services."




Research and Markets, Fax Services Market – Focused Insights 2024-2029, ResearchAndMarkets.com


Businesses in healthcare, finance, and legal sectors continue to depend on fax because of its point-to-point transmission security and compliance advantages. For organizations handling sensitive data, our Fax API enables modern, cloud-based faxing without legacy hardware.

Understanding T.38: The standard for fax over IP

T.38 is an ITU-T recommendation for transmitting faxes across IP networks in real time. As Wikipedia explains, the T.38 fax relay standard was devised in 1998 to transport faxes across IP networks between existing Group 3 fax terminals, bridging traditional fax with modern VoIP infrastructure.

Traditional voice codecs compress audio in ways that cause packet loss and jitter, which fax transmissions cannot tolerate. T.38 addresses this by converting fax signals into data packets specifically optimized for IP transmission. According to a Dialogic white paper on T.38 vs. G.711, T.38 provides superior reliability across varying network conditions and is the preferred protocol for mission-critical fax delivery.

Start using premium fax SIP trunk

To use premium fax SIP trunk, click on the Outbound menu option in your Mission Control Portal:

  1. Click +Add Outbound Profile
  2. Choose Fax Certified under Traffic Type
  3. Choose the appropriate options for the remaining fields

And you should be good to go.

For detailed configuration steps, refer to our SIP Trunking Getting Started guide in the developer documentation.

Configuring T.38 settings

By default, Telnyx will send a T.38 re-INVITE message once FAX tone is detected. You can customize this behavior through your connection settings. Our support article on Fax service with Telnyx via T.38 or G711 provides detailed configuration instructions for both inbound and outbound fax.

For advanced configuration options including T.38 re-INVITE control, refer to our guide on SIP Connection: Inbound & Outbound Settings.

Fax transmission options compared

Understanding your fax transmission options helps you choose the right configuration for your use case:

Feature T.38 Protocol G.711 Pass-Through Traditional PSTN Fax
Transmission method Data packets over IP Audio encoding over IP Analog signal over copper
Bandwidth efficiency High (optimized packets) Low (64 kbps uncompressed) N/A
Packet loss tolerance High (built-in redundancy) Low (no error correction) N/A
Error correction T.38 native ECM Dependent on endpoint Native ECM
HIPAA suitability Excellent (encrypted, real-time) Good with proper config Good (point-to-point)
Best for Enterprise FoIP, healthcare Legacy system compatibility Traditional offices
Telnyx support Full support Full support Via SIP gateway

SIP trunk vs VoIP vs fax service: Understanding the differences

Aspect SIP Trunking VoIP Services Cloud Fax Service
Primary use Voice, video, messaging, fax Voice calls Document transmission
Protocol SIP (Session Initiation Protocol) Various (SIP, H.323, proprietary) T.38 or G.711 over SIP
Infrastructure Connects PBX to PSTN via IP End-user phone service API or portal-based
Scalability Unlimited channels Per-user licensing Per-page or unlimited
Hardware required IP-PBX or SBC IP phones or softphones None (cloud-based)
Fax capability Native with fax-certified profile Often requires gateway Native
Best for Enterprises with existing PBX SMBs, remote workers High-volume document workflows
Telnyx solution Elastic SIP Trunking Voice API Fax API

Learn more about these distinctions in our comprehensive guide: SIP vs VoIP: Breaking down the key differences.

Using conversational profiles for fax

Sending fax traffic over a conversational profile? Not a problem. We'll still accept fax traffic sent using a conversational outbound profile and will complete these faxes as a best effort service. However, if completing your faxes reliably is important, we recommend using the dedicated fax outbound profile.

For organizations building fax into their applications, our Programmable Fax API documentation provides everything you need to send, receive, and manage faxes programmatically.

Why healthcare providers choose SIP-based fax

Healthcare organizations face unique compliance requirements that make secure faxing essential. Our article on why hospitals still use fax explains how regulatory requirements like HIPAA, combined with interoperability challenges between EHR systems, keep fax as the preferred communication method for protected health information.

Key benefits of T.38 fax over SIP for healthcare:

  • HIPAA compliance: Encrypted signaling and media with no data stored during transmission
  • Delivery confirmation: Real-time verification that documents arrived intact
  • Audit trails: Complete logging for compliance documentation
  • Integration: Connect with existing EHR and practice management systems

Learn more about leveraging Fax APIs for workflow automation to modernize document handling while maintaining compliance.

Industry applications

Telnyx fax SIP trunking serves organizations across multiple sectors:

  • Healthcare: HIPAA-compliant transmission of patient records, prescriptions, and referrals. See our healthcare solutions.
  • Financial services: Secure transmission of contracts, authorizations, and compliance documents. Explore our finance solutions.
  • Managed service providers: Offer fax services to clients alongside voice and messaging. Learn about our MSP use cases.
  • Unified communications: Integrate fax into your UCaaS platform for comprehensive business communications.

Getting started

Set up your fax SIP trunk today through Mission Control.

For a complete understanding of SIP trunking fundamentals, read our guide: What is SIP Trunking? Session Initiation Protocol Explained.

If you have any questions, please don't hesitate to contact us. Our support team is available 24/7 in Mission Control.


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