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Creating Secure Web Forms: What You Need to Know

person filling out a secure web form on a laptop

Creating secure web forms starts with creating a secure website. This process is more complex than creating web pages and adding an SSL Certificate. A certificate is a solid first step, but it only goes so far as to protect whatever sensitive data necessitates security in the first place.

Naive attempts at security can ultimately make the data less secure and more likely to be compromised by creating an appetizing target for the unscrupulous.

So, what do you do beyond hiring a developer with significant security expertise? Start with this article. Its purpose is to shed light on many of the most significant factors in creating secure web forms and how to address them. At a minimum, reading this article will help you intelligently discuss website security with the developers you hire.

person filling out a secure web form on a laptop

What Is Involved In Creating Secure Web Forms?

If you want to add a secure web form to your website, first, you must understand how to securely configure the website. Website security is a serious and complex topic; this article only discusses the high points. Check out some of our other articles and eBooks for more detailed information on website security.

Here are some of the critical issues that need to be considered:

  1. SSL – Is the website and form secured to transmit data from the end user safely? Is your website form page protected with SSL to prevent tampering with its contents?
  2. Web page content – Is the HTML content sent to the end-user protected from Cross-Site Scripting (XSS) issues, and does it avoid loading objects insecurely or from third parties?
  3. Script Security – Are the scripts or programs that process the submitted data written with security in mind? Do they have any vulnerabilities?
  4. Infrastructure – Is the website hosting provider trusted and known for good security? Are you on a shared server when you should be on a dedicated one?
  5. Data Flows – What do you do with the data once submitted? Is that data secured?
  6. Tracking – Do you track events such as data access and submission?
  7. Archival and Backup – Are there processes to make backups and permanent archives of important data?

SSL – Web Security Starts Here

SSL certificates are required for creating a secure website and form. The SSL certificate allows:

  1. The encryption of data sent to and from your web server and users to prevent eavesdropping or tampering.
  2. Your users trust that they are connecting to your website securely.

An SSL certificates on a properly configured web server encrypts your website data as it flows to and from your end users.

To get an SSL certificate, you can order one directly from a third party, or your web hosting provider will handle it for you. In either case, the web host will need to install the certificate on the server where the website is hosted, and then you will need to make changes to your site to take full advantage of the secure channel you have added.

SSL and Encryption

The most significant reason people use SSL is to encrypt the data transmitted from their website and the end-user. When an end-user visits a page protected by SSL, their web browser communicates over a secure channel with the web server so that all data transmitted is sent over this encrypted channel. This helps prevent eavesdropping and man-in-the-middle attacks on the data (more on these below).

Without SSL encryption, there is little or no protection of the data.

SSL and Trust

The most overlooked and misunderstood aspect of SSL is the establishment of trust. That is, enabling your end-users to trust and feel confident that they are connecting to your website. What else could they be connecting to, you may ask?

  1. Someone with access to the network between the end-user and website could be trying to intercept and read all the web traffic or altering your website pages themselves (e.g., changing your forms to submit the data to them instead of you). This is called a man-in-the-middle attack. Even with SSL security, a man-in-the-middle can present the end-user with an SSL Certificate for your domain name that looks legitimate, like a forged ID card.
  2. The user could be visiting another website that is pretending to be yours. This phishing website could collect information from your users for malicious purposes. Unless your users identify this site as illegitimate, they could be duped into revealing personal information. How could they end up at a phishing website like this? This can happen by clicking on a link emailed to them or by visiting a misspelled version of your URL. No site is immune from such attacks, but you can work to mitigate them.

SSL Certificates and Cybersecurity

As mentioned above, SSL certificates are not the sole website and form security solution, but they can help! To understand how it’s worth looking at how certificates are awarded. SSL certificates are signed by a third-party authority, the “Certificate Authority.” This can be:

  1. You, if you sign your certificates.
  2. A respected third-party issuing:
    1. A cheap or free certificate validating only your domain.
    2. A more expensive “Extended Validation” certificate which also validates your organization.

If you sign your own certificates, your website will generate warnings when anyone visits it. Users can choose to dismiss them, but more commonly, they will be more likely to navigate away from the website. For this reason, self-signed certificates are never recommended for a public website. Self-signed certificates provide no inherent trust that they are legitimate (anyone can generate one and pose as your site). They look amateurish and are annoying to the end user. Self-signed certificates should only be used in internal or test environments.

When ordering a certificate from a trusted third-party authority, there are various types that you can order. The cheapest ones are called domain-validated certificates. These work by emailing your domain administrator a validation link. Once verified, the certificate is awarded. These domain-validated certificates are acceptable and provide excellent security; however, as no humans are directly involved in the validation process, it may be easier for an attacker to get an illegitimate certificate by gaining control of the admin’s inbox or via other methods.

You can also order Extended Validation certificates. They cost more because real people validate the organization and your domain ownership. They make phone calls and ensure that everything looks right. If you have one of these certificates, your browser’s address bar turns green (or displays a lock symbol) when visitors come there to indicate that this site is trusted. If you want to maximize trust and make it easy for your end-users to identify your site as legitimate, you should use an Extended Validation certificate. These cost more but are well worth it in terms of security and trust. If EV certificates are outside your budget, you should still use an SSL certificate from some trusted third party.

Securing Web Forms with SSL

Once your website has an SSL certificate installed by a web host, your web pages can be accessed with addresses that start with “https://” instead of just “http://.” The “s” in “https” means “secure.” Note:

  1. When connected to a web page using a secure address like “https://yourdomain.com,” the web browser will show a lock icon to inform you that the connection is secure.
  2. Web pages that end in “.shtml” are not necessarily secure. The “s” means “server” (i.e., server-parsed page) and not “secure.” So, for example, “http://yourdomain.com/index.shtml” is not a secure page, but “https://yourdomain.com/index.html” is a secure page.
  3. With SSL enabled, you can access the same page securely and insecurely in many default web server configurations. Both “http://yourdomain.com/form.html” and “https://yourdomain.com/form.html” work and show the form — the only difference is the use of SSL or not.

So, let’s say that you have a web form located at “http://yourdomain.com/form.html.” You have an SSL certificate, and your web host has installed it. Next, you want to:

  1. Make sure people connect securely to the form page.
  2. Make sure that no one can connect to the form page insecurely.

These two goals might sound the same, but they are not.

Enforce Secure Connections to Form Pages

Since regular website pages may be insecure, you need to ensure that the links to the secure form page are absolute links starting with the prefix “https://.” This will ensure that anyone clicking these links will be taken to the form page on a secure connection.

The best solution is to use an HSTS (HTTP Strict Transport Security), which tells browsers that they should always use the secure version of your website. If you choose to have both the insecure (http) and secure (https) versions of your site running at the same time (not recommended), then you need to be careful with linking so that sensitive pages are secured:

Wrong Links: Relative links are not recommended because, if the user is on an insecure page, relative links will always take them to insecure versions of the destination page. So relative links like the following should be avoided:

Fill out my form!

Correct Links: Absolute links will ensure a secure connection by specifying that SSL must be used via the link prefix “https://.”

For example: <a href=”https://yourdomain.com/form.html”>Fill out my form!

Be sure that all links to all secure pages of the site use this secure format with the “https://” prefix.

Side Note: These days, it is recommended that you use SSL for all website pages, not just ones that process sensitive information. This is good for user trust, security, and privacy. It is also good for Search Engine Optimization (as Google will reward you for securing your site). If you set up your site so all pages are always secure, relative links are safe.

Ensure No One Can Connect to Form Pages Insecurely

Using the above suggestions, all the links on your website will take users to the secure version of the form. However, most web hosts leave the insecure version of the form there, and users can still access it if they enter the insecure address directly (or if links are directed to the insecure page). As a next step, you should ensure that accessing the form page via an insecure connection is impossible.

There are several different ways that this can be done. Some of these include:

Separate space for SSL pages: If your web host has this feature, you can configure the website to store web pages for secure (SSL) connections in a different directory from those for insecure pages. If this feature is enabled, the form page is placed in the secure directory and no copies are in the insecure directory. Thus, any insecure requests for these pages would result in a “page not found” error. You could then implement server-side redirection rules where if someone requests the insecure page, they are automatically redirected to the secure version (this can be done using .htaccess files and the “Redirect” directive). If you did this, secure and insecure requests for the page would take the user to the secure version with no errors, warnings, or issues for the end user.

Scripted pages: If the form page is generated by a server-side script (i.e., PHP, Perl, Python, or JAVA), then the script itself can determine if the request is secure or not (e.g., by looking at the server environment variables). For secure requests, it can render the form as usual. The user receives an error for insecure requests or is redirected to the proper secure location. 

Securing all pages: (Recommended) The site can be configured to automatically redirect all requests for insecure pages to the respective secure page. All pages will be secure, and any accidental/incorrect requests for the insecure pages will still get people to the right place. Security is greatly improved if you have set this up.

If my form is posted to a secure form processing script, why does it need to be secured?

This question is usually asked when a third-party manages the form processing. Is securing the form itself with SSL needed?

The answer is based on the following facts:

  1. The data sent from end-users to the server will be secure and encrypted during transmission. This is critical for creating secure websites and forms that require HIPAA compliance.
  2. Non-technical end-users will only know if their data is securely submitted once it is done. Many end-users will refrain from submitting sensitive data to an insecure form on your site.
  3. End-users cannot know if they are viewing your website or a phishing site or if eavesdropping and modification are happening. Many users will not trust the connection and will not want to submit their data through your site if it appears insecure.
  4. If your form page is insecure, it is straightforward for any malicious party to perform a man-in-the-middle attack to eavesdrop on connections, modify your form in transit to change what is collected and where the data is sent, and set up phishing sites. Your end-users can’t tell if this is going on.

If you do not secure your web form with SSL, it is vulnerable to attack. If nothing is going on, you can rely on transmission security. However, that minimal level of security is not recommended for production websites or anywhere that compliance is required.

Other Aspects of Creating Secure Web Forms

Proper use of SSL for encryption and trust is only part of creating secure website forms. You must be concerned with many other aspects to protect your users, your application, and your company’s reputation. These include (but are not limited to):

1. Cross-Site Scripting (XSS). Suppose you include dynamic content on your web pages (i.e., information submitted by other users or content submitted via form fields), and that content is not cleaned of JavaScript and HTML. In that case, bad actors could make arbitrary content appear on your website, capture user data, or worse. All data displayed should be clear of undesirable content (script tags, special characters, HTML, and other things). This is one of the most significant security issues with dynamic web pages across the internet.

2. Secure Server-Side Programming: The scripts and programs that accept and process the data from online forms must be created with security in mind. They must validate all submitted data as needed without making assumptions about its format and content. The scripts must not provide avenues for attacks like SQL Injection. Scripts must not use submitted content as actual filenames or URLs for remote loading content. They should log any strange errors or problems for later analysis. They should provide a mechanism for blocking undesirable actions or users from using the scripts.

3. Validation: Validation of all input data is part of the above two points. However, it is so essential that we will repeat it and go over some of the fundamental points:

  • If you validate submitted content, always perform your validation on the server side. Even if you use JavaScript to validate the data on the client side, you should always re-validate it on the server side. Why? Because people can get around JavaScript and submit arbitrary content directly to your scripts. The scripts should be prepared to handle that.
  • Always de-taint submitted data. What does that mean? It means never trust submitted data and take pains to ensure that the submitted data matches what you expect. For example, if you have a select list that sends your script a number as the value, do not assume you are getting a number. Instead, check that it is a numeric value or convert whatever is submitted into a number.
  • Remove disallowed content from the text submitted by users. Remove or block special characters, embedded codes, and other things that should not be there.
  • Ensure the submitted data is manageable enough to be used.
  • Do not assume anything — program defensively.

4. Preserving State with Hidden Form Fields or Cookies: If your program remembers information from one page to another by saving the data in hidden form fields, then your program must also ensure that the content of those fields was not tampered with. One good way to do this is to make a hash of all the data, together with a secret value, and include that hash in the form data. Then, when the form is submitted, you can recompute the hash and compare it with what passed from the form. If they match, you are okay; if they do not, the data has been tampered with. No one can break this scheme without knowing your secret value or breaking your hashing algorithm. This method can also be used to validate data saved in cookies. You can go further and use time stamps to prevent replay attacks.

5. Third-Party Applications: If you install programs from third parties on your website, you must ensure there are no known security issues with these programs, and you must be sure to update these programs as soon as new versions are released. If you let your website languish with an older, vulnerable version of a program, it will become a target for hackers as they constantly search the internet for such websites. Your site will likely be hacked in these cases, possibly causing loss of business, deactivation of your website, and tarnishing your website’s reputation. Using a third-party application is easy, but you need to select a good one that places the burden of keeping it updated on you. An exception is using a third-party application hosted by the third party itself. In these cases, the third party ensures that the program is continuously updated with anything needed to address any security issues. The burden is on them and not you. If you choose a good, respectable vendor, you should have no problems.

All these things, and more, are critical to developing a secure web application.

Securing the Form Data After Submission

Ensuring that users’ data is transmitted securely to your web server is critical, as is ensuring that your application is secure and will not be hacked. To secure sensitive data, you must understand what happens to that data after your program receives it. Many people forget that transmitting the data from the web server may require just as much preparation as receiving it from their users in the first place.

In the following subsections, we will look at three different ways of saving and retrieving your users’ data. In each case, we will explain what is needed to secure the data in your systems.

Send Form Data via Email 

The most common action data processing scripts do is email the submitted data to the website owner’s email address. The website owner knows when there are new submissions by checking their email and can access the data immediately. Most people running websites check their email reasonably often, which integrates well with their business operations.

However, the standard ways of sending emails are entirely insecure. So, how can you use email while ensuring the data is secure and viewable only by the intended recipient?

  1. Have your website script encrypt the data.
  2. Send this encrypted data (or a link to download the encrypted data) to the intended viewers via regular email.

As the form data is encrypted within the email message, most insecurities inherent in email are obviated. You can also use secure third-party services to have your form data emailed to you securely without programming anything yourself.

Save the Submission in a Database

Many website owners like to save the submitted form data in a database (even if it is also emailed to someone). Why?

  1. The data is saved online and potentially accessible from anywhere.
  2. If the emailed copies of the data are lost, the copies in the database are still there.
  3. The database can be accessed through a web browser with a suitable user interface.
  4. The data is typically backed up and can be restored.

If storage in an online database is for you, then you need to:

  1. Use encryption, like SSL or PGP, to ensure the data is securely stored in the database. Why? The contents of database tables are not encrypted or secure in general. Storing unencrypted data makes it available to anyone with access to the database or its backups.
  2. Provide a user interface that allows you to access the database data. It must be secure, have robust access controls, and provide a means for decrypting the data.

The database option requires much work to make a secure and usable solution. For this reason, most small organizations do not end up using secure database storage for important form data.

Save the Data in Files

The file storage option is the “quick and dirty” alternative to secure database storage. Essentially, your program will:

  1. Make a file containing the form data.
  2. Encrypt that file using PGP or SSL.
  3. Save that encrypted file in a directory on the web server that is not accessible from the website. Another option is to save it in an online file-sharing service.

Then, the website owners can log in to the web server using Secure FTP and download these files as needed. They can be decrypted locally when the data must be accessed. Other simpler data access mechanisms are available if the files are saved in an online file share.

This solution is secure and provides an excellent backup to securely emailed data.

Other Technical Tips for Creating Secure Website Forms

There are many other considerations in developing and maintaining a secure website and forms. It would be impossible to cover or even list them all. However, here are some more interesting and valuable tips.

Use Secure Cookies

If your secure site uses cookies for anything, set the “secure” cookie and the “httpOnly” flags. This will ensure that these cookies are never sent insecurely over the internet when the visitor arrives at any insecure pages of your website (they are not sent at all to insecure pages) and thus helps preserve the security of the contents of these secure cookies.

Prevent Form Spam

Form spam occurs when automated programs find your web forms and try to send spam through them. Form spam can result in hundreds or thousands of useless form posts daily. Once you start getting form spam, stopping it is a priority. There are two primary ways to help prevent spam:

  1. CAPTCHA – This method requires end-users to read text embedded in an image and type that text successfully into a form field. The back-end program then validates this. Since most spam programs cannot read text embedded in images, it will successfully block almost all automated forms spam. However, CAPTCHA requires the users to perform one more step, which can be annoying.
  2. JavaScript and Cookies – Most automated form spam programs do not process JavaScript or use cookies. If your web form requires JavaScript to submit the form successfully, bots cannot do this, and most form spam will be blocked. This method is less reliable than CAPTCHA but does not require any extra work from the end-user. Note that if you wish to use the JavaScript method, you must be sure that arbitrary submissions to the default action URL of your forms will never succeed—only submissions made after the execution of your custom JavaScript should succeed.

Minimize the Need for Trust

A good rule of thumb is to minimize the need to trust third parties and trust only the trustworthy.

  1. If you do not trust your internal IT staff, do not host your web application on your servers or give them access to the server used.
  2. If you do not trust the third-party hosting your website, encrypt the form data as soon as possible. This helps ensure that the data is not saved anywhere in plain text and is not backed up in plain text, thus minimizing your exposure to unauthorized people. Further, ensure that the private keys and passwords needed to decrypt the data are not stored on the web host’s servers.
  3. Ensure that only authorized staff can access the submitted form data. Ideally, it should always be encrypted, and only authorized people should be able to decrypt it.

These are just a few obvious points. As you evaluate your web application and data flow, ask yourself, “Who can access the raw data and how?” at each stage. Are there stages where you are trusting people who should not be trusted?

Forced use of strong encryption in SSL

The strength of encryption used by SSL is a function of both the user’s web browser and the server. Even if your web server supports excellent encryption, like AES256, the user’s browser may choose a weaker level of encryption. Older versions of Internet Explorer are notable for choosing weaker encryption in the interest of speed.

You can modify your web server configuration so that only levels of encryption you approve can be used to access your site.

Use Two-Factor Authentication

Two-factor authentication is standard on very secure sites now. You require a password and something else (a code or token) to validate their identity. With both, the user can log in. Avoid using only SMS texting as the second factor, which is no longer considered secure.

Get Started Creating Secure Web Forms

Outsourcing your form hosting and processing can be the fastest and most cost-effective way to get started. LuxSci’s Secure Form was designed for security and compliance. Contact us today to learn more about protecting sensitive information online.

Picture of Erik Kangas

Erik Kangas

With 30 years engaged in to both academic research and software architecture, Erik Kangas is the founder and Chief Technology Officer of LuxSci, playing a core role in building the company into the market leader for HIPAA compliant, secure healthcare communications solutions that it is today. An international lecturer on messaging security, Erik also advises and consults on email technology strategies and best practices, secure architectures, and HIPAA compliance. Erik holds undergraduate degrees in physics and mathematics from Case Western Reserve University, and a doctoral degree in computational biophysics from MIT. Erik Kangas — LinkedIn

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Related Posts

HIPAA Compliant Email

New HIPAA Security Rule Makes Email Encryption Mandatory—Act Now!

The 2026 Deadline Is Closer Than You Think

The upcoming HIPAA Security Rule overhaul is expected to finalize by mid-2026, and it’s shaping up to be one of the most significant updates in years. Healthcare organizations that fail to prepare, especially when it comes to email security, will face immediate compliance gaps the moment enforcement begins.

Mid-2026 may sound distant, but for healthcare IT and compliance leaders, it’s right around the corner. Regulatory change at this scale doesn’t happen overnight, it requires planning, vendor evaluation, implementation, and internal alignment.

This isn’t a gradual shift. It’s a hard requirement.

Encryption Is About to Become Mandatory

For years, HIPAA has treated encryption as “addressable,” giving organizations flexibility in how they protect sensitive data. That flexibility is disappearing.

Under the updated rule, encryption, particularly for email containing protected health information (PHI), is expected to become a required safeguard.

That means:

  • Encryption must be automatic and standard for email, not optional
  • Policies must be enforced consistently
  • Email security can’t depend on human behavior

If your current system relies on users to manually trigger encryption, it’s already out of step with where compliance is heading. If you’re not encrypting your emails at all, then now is the time to re-evaluate and rest your technology and policies.

Email Is the Weakest Link in Healthcare Security

Email remains the most widely used communication tool in healthcare—and the most common source of data exposure. Every day, sensitive information flows through inboxes, including patient records, lab results, billing details, plan renewals and appointment reminders. Yet many organizations still depend on:

  • Basic TLS encryption that only works under certain conditions
  • Manual processes that leave room for human error
  • Limited visibility into email activity and risk

It only takes one mistake, such as a missed encryption trigger or a misaddressed email, to create a reportable breach. Regulators are well aware of this. That’s why email is a primary focus of the upcoming HIPAA Security Rule changes.

The Cost of Waiting Is Higher Than You Think

Delaying action may feel easier in the short term, but it significantly increases risk. Once the new rule is finalized, organizations without compliant systems may face:

  • Immediate audit failures
  • Regulatory penalties
  • Expensive, rushed remediation efforts
  • Or worst of all, an email security breach

Beyond financial consequences, there’s also reputational harm. Patients expect their data to be protected. A single incident can immediately erode trust and damage your brand beyond repair.

Waiting until the end of 2026 also means that you’ll be competing with every other organization trying to fix the same problem at the same time, driving up costs and limiting vendor availability.

Most Email Solutions Won’t Meet the New Standard

Here’s the uncomfortable reality: many existing email platforms won’t be enough, especially those that are not HIPAA compliant. Common gaps include:

  • Encryption that isn’t automatic or policy-driven
  • Lack of Data Loss Prevention (DLP)
  • Insufficient audit logging for compliance reporting
  • Lack of Zero Trust security principles

On top of that, vendors without alignment to HITRUST certification and Zero-Trust architectures may struggle to demonstrate the level of assurance regulators will expect moving forward.

If your current solution wasn’t designed specifically for healthcare and HIPAA compliance, it’s likely not ready for what’s coming.

LuxSci Secure Email: Built for What’s Next

This is where a purpose-built solution makes all the difference. LuxSci HIPAA compliant email is designed specifically for healthcare organizations navigating the latest compliance requirements, not just today, but in the future regulatory landscape.

LuxSci delivers:

  • Automatic, policy-based encryption that removes user guesswork
  • Advanced DLP controls to prevent PHI exposure before it happens
  • Comprehensive audit logs to support audits and investigations
  • Zero Trust architecture that verifies every user and action

Additionally, LuxSci is HITRUST-certified, helping organizations demonstrate a mature and defensible security posture as regulations tighten. Email data protection isn’t about patching gaps, it’s about eliminating them.

Act Now or Pay Later

If there’s one takeaway, it’s this: the time to act is now. Start by asking a few direct questions:

  • Is our email encryption automatic and enforced?
  • Do we have full visibility into email activity and risk?
  • Is our vendor equipped for evolving HIPAA requirements?

If the answer to any of these is unclear, now’s the time to take action. Organizations that move early will have time to implement the right solution, train their teams, and validate compliance. Those that wait will be forced into reactive decisions under pressure.

Conclusion: The Time to Act is Now!

The HIPAA Security Rule overhaul is coming fast, and it’s raising expectations across the board. Encryption will no longer be addressable, but rather mandatory. As a result, email security can no longer be overlooked, and compliance will no longer tolerate gaps.

LuxSci HIPAA compliant email provides a clear, future-ready path for your organization, combining automated encryption, DLP, auditability, and Zero Trust security in one solution.

The real question isn’t whether change is coming. It’s whether your organization will be ready when it does.

Reach out today. We can look at your existing set up, help you identify the gaps, and show you how LuxSci can help!

FAQs

1. When will the updated HIPAA Security Rule take effect?
The changes to the HIPAA Security Rule are expected to be finalized and announced around mid-2026, with enforcement likely soon after, by the end of the year.

2. Will email encryption truly be mandatory?
Yes, current direction strongly indicates encryption will become a required safeguard, which could start later this year or in early 2027.

3. Is TLS encryption enough for compliance?
No. TLS alone does not provide sufficient, guaranteed protection for PHI.

4. Why is HITRUST important in this context?
HITRUST certification demonstrates a vendor’s strong alignment with healthcare security standards and will likely carry more weight with regulators.

5. How does LuxSci help organizations prepare?
HITRUST-certified LuxSci offers secure email with automated encryption, DLP, audit logs, and Zero Trust architecture, helping organizations meet evolving compliance demands.

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LuxSci G2 2026

LuxSci Earns 19 G2 Spring 2026 Badges

LuxSci continues its strong performance in the G2 Spring 2026 Reports, earning 19 badges that reflect real customer satisfaction and consistent product excellence across multiple areas, including email encryption, HIPAA compliant messaging, email security and email gateways.

G2: A Highly Reputable Peer Review Platformn

In a crowded software landscape, it’s easy for bold claims to blur together. That’s where G2 stands apart. Its rankings are based entirely on verified user feedback, giving buyers a clearer picture of how solutions actually perform in day-to-day use, not just how they’re marketed.

For Spring 2026, LuxSci earned recognition across multiple categories, including Leader, Best Customer Support, and Best ROI. Together, these awards show that LuxSci delivers leading technology and a best-in-class customer experience.

What the Badges Represent

Each G2 badge reflects direct input from customers using LuxSci in real-world environments. These evaluations cover usability, onboarding, support responsiveness, and long-term value. LuxSci’s Spring 2026 badges span leadership, customer satisfaction, ROI, and ease of implementation, demonstrating consistent strength across the full customer lifecycle.

Leader Badge: Market Leadership Validated

The Leader badge is awarded to companies with high customer satisfaction and strong market presence. LuxSci’s placement reflects reliable performance, strong security, and continued trust from organizations operating in highly regulated environments like healthcare.

Best Customer Support: A Standout Strength

In secure healthcare communications, timely and accurate support is essential. Issues must be resolved quickly to avoid operational or compliance risks. Customers consistently highlight LuxSci’s fast response times, deep expertise, and a hands-on approach, showing that our technology and our people deliver meaningful, real-world solutions.

Best ROI: Proven Business Value

ROI includes reduced compliance risk, improved efficiency, and scalable operations, not just cost. Customers report measurable benefits from LuxSci’s reliability, built-in compliance, and streamlined workflows, leading to strong long-term value and a solution that keeps you ahead of security and compliance risks.

What This Means for LuxSci Customers

These awards show LuxSci’s ability to serve organizations of varying sizes, from mid-market to enterprise. All reviews are from verified users, ensuring authenticity and transparency. Customers consistently mention reliability, security, and responsive support, along with overall peace of mind. The recognitions validate LuxSci’s ability to deliver secure, dependable communication solutions backed by strong support, including HIPAA compliant email, marketing and forms.

LuxSci’s 10 G2 Spring 2026 badges—including Leader, Best Customer Support, and Best ROI—demonstrate consistent excellence across performance, usability, and customer satisfaction. These results reinforce its position as a trusted provider in secure communications.

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LuxSci MFA

Traditional MFA No Longer Qualifies as “Reasonable” Security

For years, multi-factor authentication (MFA) was considered one of the most effective ways to protect sensitive systems. By requiring a second verification step, such as a text message code or push notification, organizations could significantly reduce the risk of compromised passwords.

But the threat landscape has changed.

Today, attackers routinely bypass traditional MFA using techniques such as MFA evasion, token replay attacks, and consent phishing. These methods are no longer rare or highly sophisticated. They are widely used, automated, and increasingly effective.

As a result, regulators, auditors, and security frameworks are raising expectations for authentication security. For healthcare organizations in particular, traditional MFA alone may no longer satisfy the HIPAA requirement to implement “reasonable and appropriate safeguards.”

In the near future, email systems that rely only on basic MFA, without conditional access or phishing-resistant authentication, may increasingly be viewed as security gaps during risk assessments.

Why Traditional MFA Is No Longer Enough

Traditional MFA still improves security compared to passwords alone. However, many common MFA methods were designed before today’s phishing techniques and cloud authentication attacks became widespread.

Common MFA methods include:

  • SMS verification codes
  • Email-based authentication codes
  • Push notifications to mobile apps

While these mechanisms add friction for attackers, they can still be intercepted or manipulated during sophisticated phishing attacks. Because modern attackers now target authentication workflows directly, organizations relying solely on traditional MFA may be more vulnerable than they realize.

How Attackers Bypass MFA Today

Cybercriminals increasingly rely on tools that capture credentials and authentication tokens during login sessions. Three attack techniques are now especially common.

  • MFA Evasion and Phishing Proxies – Attackers frequently deploy adversary-in-the-middle phishing kits that sit between the user and the real login service. When users enter their credentials and MFA code on a phishing page, the attacker forwards the information to the legitimate site and captures the authentication session. The user successfully logs in—but the attacker gains access as well. If attackers capture those tokens, they can reuse them to access the account directly.
  • Token Replay Attacks – After successful authentication, systems typically issue session tokens that allow users to remain logged in without repeated MFA prompts. This technique has been widely observed in attacks targeting cloud email platforms such as Microsoft 365, allowing attackers to access email data even when MFA is enabled.
  • Consent Phishing – Consent phishing bypasses MFA entirely. Instead of stealing passwords, attackers trick users into granting permissions to malicious applications that request access to their mailbox or files. If users approve the request, the attacker’s application receives persistent access to the account through APIs—often without triggering security alerts.

Why Email Authentication Matters Most in Healthcare

Email remains one of the most critical systems in healthcare organizations. It supports patient communication, internal collaboration, and the exchange of sensitive information. Unfortunately, it is also the most frequently targeted entry point for cyberattacks.

Once attackers gain access to an email account, they can:

  • Impersonate healthcare staff
  • Launch internal phishing attacks
  • Access sensitive patient communications
  • Extract protected health information (PHI)

Because of this, email authentication controls are becoming a major focus for security teams and compliance auditors alike.

Evolving Regulatory Expectations

HIPAA does not prescribe specific technologies, but it requires organizations to implement safeguards that are “reasonable and appropriate” based on risk. As new attack methods emerge, the definition of reasonable security evolves.

Today, many security frameworks and regulatory bodies are emphasizing stronger identity protections, including:

  • Phishing-resistant authentication
  • Conditional access policies
  • Monitoring for suspicious login behavior
  • Controls for third-party application permissions

Organizations that rely solely on basic MFA may increasingly struggle to demonstrate that their authentication protections are sufficient.

The Shift Toward Phishing-Resistant Authentication

To address the weaknesses of traditional MFA, many organizations are adopting phishing-resistant authentication technologies, which can be enabled with tools like Duo and Okta. These solutions rely on cryptographic authentication tied to trusted devices, which prevents attackers from capturing or replaying login credentials.

Examples include:

  • Hardware security keys
  • Passkeys
  • Certificate-based authentication

Because authentication is tied to both the device and the legitimate website domain, these technologies significantly reduce the success rate of phishing attacks.

Why Conditional Access Is Becoming Essential

Conditional access adds another layer of protection by evaluating context and risk before granting access. Instead of treating every login the same, conditional access policies analyze signals such as:

  • Device security status
  • Geographic location
  • Network reputation
  • User behavior patterns

If something appears unusual, such as a login from a new country, the system can require stronger authentication or block the attempt altogether. This risk-based approach to authentication helps prevent many account compromise scenarios.

The Future of HIPAA Risk Assessments

As authentication threats evolve, healthcare security assessments are increasingly focusing on identity protection maturity. Organizations may begin seeing findings related to:

  • Weak or outdated MFA methods
  • Lack of conditional access policies
  • Insufficient monitoring of login activity
  • Unrestricted third-party application permissions

In particular, email systems without advanced authentication protections may be flagged as high-risk vulnerabilities, especially when PHI is accessible.

LuxSci’s Modern Approach to MFA

Modern threats require more than a simple second login factor. LuxSci approaches authentication security with layered identity protection designed specifically for healthcare environments.

Instead of relying solely on basic MFA methods like SMS codes or email verification, LuxSci supports stronger authentication controls and policies that align with evolving security expectations. These protections can include:

  • Strong multi-factor authentication options
  • Monitoring for unusual login behavior
  • Enhanced identity verification mechanisms

By combining multiple security layers within its HIPAA-compliant secure communications email and marketing solutions, LuxSci helps healthcare organizations protect sensitive email communications while maintaining usability for providers, health plan administrators, payment providers, and patient engagement teams.

Conclusion

Multi-factor authentication remains an important security control—but not all MFA is created equal. Attack techniques such as phishing proxies, token replay, and consent phishing have demonstrated that traditional MFA methods can be bypassed. As a result, regulators and auditors are increasingly expecting stronger identity protections.

For healthcare organizations that rely heavily on email communications, the implications are significant. Weak authentication controls can expose sensitive patient data and may soon appear as high-risk findings during HIPAA risk assessments. The organizations best positioned for the future will be those that modernize authentication strategies now, moving toward phishing-resistant methods, conditional access policies, and layered identity protection.

Reach out to LuxSci today to learn how HIPAA compliant email can support both your organization’s engagement and cybersecurity needs.

FAQs

1. What is traditional MFA?

Traditional MFA refers to authentication methods that require a second verification step, typically SMS codes, email codes, or push notifications.

2. Why can attackers bypass MFA today?

Modern phishing tools can intercept authentication sessions or steal login tokens, allowing attackers to access accounts even when MFA is enabled.

3. What is phishing-resistant authentication?

Phishing-resistant authentication uses cryptographic methods tied to trusted devices, preventing attackers from capturing login credentials.

4. Why is email security especially important for healthcare organizations?

Email systems often contain patient communications and sensitive information, making them a common target for cyberattacks.

5. How can organizations improve authentication security?

Organizations can strengthen identity security by adopting phishing-resistant authentication methods, implementing conditional access policies, and monitoring login activity.

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LuxSci Automated Email Encryption

Encryption Optional Email Will Fail Audits in 2026 and Beyond

For years, healthcare organizations have relied on click-to-encrypt email workflows and secure portals as a practical compromise between usability and compliance. Or in some cases, they simply thought most of their emails did not need to be compliant. In regulated industries where data security and privacy are paramount, this approach was still considered “good enough.”

That era is ending.

As we progress into 2026 and beyond, regulators, auditors, and cyber insurers are sending a clear and consistent message: encryption that depends on human choice is no longer acceptable. It’s already happening. Encryption optional email isn’t merely raising concerns, it’s failing audits outright.

An Email Threat Landscape That’s Changing Faster Than Email Habits

Historically, email encryption was treated as a best practice rather than a hard requirement. If an organization could demonstrate that encryption tools existed and that employees had access to them, auditors were often satisfied. The box was checked, everybody moved on.

Today, the questions auditors ask are fundamentally different. Instead of asking whether encryption is available, they are asking whether sensitive data can ever leave the organization unencrypted. If the answer is yes, even in rare cases, or even accidentally, that’s no longer viewed as an acceptable gap. It’s viewed as inadequate control.

Why 2026 Is a Tipping Point for Email Security

Several forces are converging here in 2026 that make optional encryption increasingly untenable. Regulatory scrutiny around PHI and PII exposure continues to intensify. Breach costs and litigation are rising, with email remaining one of the most common vectors for data exposure and breaches. AI is also changing the game for cybercriminals, and attacks will continue to increase and be more sophisticated. As a result, cyber insurers are tightening underwriting requirements and demanding stronger, more predictable controls.

At the same time, email user behavior is unpredictable and inconsistent, which is a non-starter for data security in today’s world.

Taken together, these trends and behaviors point to a single requirement: email security controls must be automated. They must be enforced by systems, not dependent on employee memory, judgment, or good intentions.

The Reality of “Encryption Optional” in Practice

On paper, optional encryption can sound reasonable. In practice, it creates gaps large enough to open you up to a breach.

Secure portals are a good example. They require recipients to click a link, authenticate, and access content in a controlled environment. While this protects data in transit, and is a better approach than no security at all, it also introduces friction. And people don’t like friction. Senders forget to use the portal. Recipients ask for “just a quick email instead.” Shortcuts are taken to save time. And every shortcut becomes a risk.

Click-to-encrypt systems suffer from a similar problem. They rely on users to correctly identify sensitive data and remember to take action. But people often misclassify information, forget to click the button, or assume someone else has already secured the message. From an auditor’s perspective, this isn’t a training failure. It’s a set-up and control failure.

Email Security Defaults Are the New Normal

The latest message from regulators, auditors, and insurers is clear. If encryption is optional, data vulnerabilities become inevitable.

What can you do?

Below is a quick email security checklist to help you get started. Cyber insurers may require or recommend the following safeguards during the underwriting process, such as:

  • Multi-factor authentication (MFA)
  • Endpoint protection
  • Encrypted backups
  • Incident response planning
  • Encryption protocols for sensitive data in transit and at rest, including PHI in emails

In 2026 and beyond, healthcare organizations and regulated industries will be judged not by what they allow, but by what they prevent. Automated, encrypted email is the new. normal.

Want to learn more about LuxSci HIPAA compliant email? Reach out today.

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patient engagement tools

Why Healthcare Insurers Should Send Explanation of Benefits Statements Via Email

Explanation of Benefits statements or EOBs are mission-critical communications for health insurers because they ensure transparency, help detect billing errors or fraud, and most importantly, keep patients informed about their benefits and related payments.

However, the most conventional method of sending out EoBs, traditional mail, has several drawbacks that can prevent important information about healthcare coverage from reaching the intended recipient. This can leave policyholders in the dark about their healthcare coverage, which can lead to confusion and dissatisfaction with their insurance provider when they receive an unexpected medical bill. This can also drive up inbound calls into your claims department or contact center.

Because Explanation of Benefits statements contain the protected health information (PHI) of policyholders, insurers are bound by HIPAA (the Health Insurance Portability and Accountability Act) regulations to ensure their secure delivery. Consequently, the risks inherent to sending paper EoB statements in the mail not only have security implications but also potential consequences for non-compliance.

With all this in mind, this post discusses why healthcare insurers should send EoBs to their policyholders via secure email instead of traditional mail. We detail the various benefits of making the switch to electronic EoBs, which include enhanced security, better adherence to compliance regulations, and the opportunity to save millions of dollars per month.

Protecting Patient Privacy

The primary reason that insurance companies should shift to email EoBs as opposed to traditional mail is that it’s far more secure. Sending an EoB via email drastically decreases the risk of protected health information (PHI) getting into the wrong hands. When sent in paper form by mail, an EoB could be:

  • Lost, stolen or damaged in transit
  • Delivered to the wrong address
  • Not properly deposited in a letter or mailbox, then stolen
  • Intercepted within the intended address by another individual who lives at or has access to the residence.

As detailed later in this post, email also allows for various controls and processes, which mitigate the risks of unsuccessful message delivery.

Most importantly, secure email provides data encryption, which safeguards the sensitive patient data within EoBs during transmission and when stored by rendering it unreadable to malicious actors who might intercept it. Physical mail, in contrast, offers no such protection, as someone who intercepts a paper EoB form can simply open it and freely read its contents.

Finally, secure email delivery platforms feature identity verification and access controls that enable healthcare insurers to restrict access to PHI to authorized personnel, limiting its exposure. They also provide auditing capabilities to track access to patient data, and quickly identify the source of security breaches.

HIPAA Compliance Benefits

Because sending an Explanation of Benefits statement via email is more secure, and better protects any patient data contained within them, this also reduces the risk of HIPAA compliance violations.

First and foremost, HIPAA regulations mandate that communications containing PHI, such as EoBs, must securely reach the intended recipient. By eliminating the risk of physical interception or non-delivery, and the compliance violations from a resulting security breach, insurers can better adhere to HIPAA regulations using email for sending EOBs. On a similar note, the security features built into a HIPAA compliant email platform, such as encryption, access controls, and audit logs, help insurers to satisfy the requirements of HIPAA’s Privacy and Security Rules in their compliance efforts.

Another considerable benefit of using secure email to send policyholders their EoBs, or, in fact, any communication containing PHI, is that it’s far easier to implement breach notification protocols. Email delivery platforms provide real-time tracking, so companies can pinpoint email message failures quickly and act accordingly. Similarly, intrusion detection systems and other cybersecurity measures that support email systems can enable faster detection and containment of data breaches.

In stark contrast, physical mail is far more difficult to track – and even those limited capabilities are reserved for more expensive delivery options. Consequently, security breaches via mail could go unnoticed for days or even weeks. If you’re unaware of a data breach, or have not yet contained or mitigated it, you’re then unable to inform all affected parties, resulting in further HIPAA violations.

Increased Deliverability Rates

By greatly mitigating the security risks presented by physical mail, i.e., the various ways an EoB could fall into the wrong hands, sending an EoB by email increases your ability to get more EOBs into the hands of policyholders, more quickly. At the same time, policyholders can make faster decisions regarding their healthcare.

The ability to track secure email gives you greater control over EOB deliverability, as it allows organizations to determine the cause of delivery failure and can also make subsequent attempts. Additionally, the process of determining the reason for the message delivery failures can also reveal security issues; the same process, however, is very difficult to achieve with traditional mail.

Here’s how the typical protocol for resending a secured email goes beyond what you can do with managing traditional mail delivery:

  • Determine the cause of non-delivery: verify that the intended recipient information is correct and check for issues like a full email inbox or security misconfigurations.
  • Don’t automatically resend: to avoid exposing PHI to the wrong person, confirm the intended recipient’s email address through an alternative verified channel, e.g., phone call, secure SMS, etc.
  • Log the incident: document the delivery failure, steps taken to determine its cause, attempts, etc.
  • Reattempt message delivery: if the investigation deems it safe, attempt message redelivery with the corrected information.

In the event that subsequent delivery attempts fail, it’s best practice to contact the individual to arrange the most convenient and secure alternative to deliver their EoBs.

Cost Savings

Simply put, sending Explanation of Benefits statements via email instead of traditional mail saves health insurers money – potentially lots of it. Processing EOBs from start to finish can cost health insurers one to two dollars or more per EOB. That’s a lot. The biggest opportunity for cost reduction is tied to the money saved on printing and mailing paper EoB statements. Additionally, the cost of administering the delivery of EoB forms, ensuring their delivery, etc., is lowered when it’s done electronically. Not to mention, resending EoBs in the event of their non-delivery is much easier and cheaper via email.

In a broader sense, increasing the deliverability and the success rate of sending EoBs helps a larger number of policyholders better understand the details of their insurance coverage, i.e., how it works, which services and procedures it covers, etc. As a result of their policyholders being more informed, insurers won’t spend as much time explaining policy details and cost breakdowns to their members, allowing them to divert the otherwise required resources to other areas of the business.

Reduced Carbon Footprint

Finally, it’s difficult to highlight the benefits of sending EoBs to policyholders by email without recognizing the positive environmental impact, too. Email EoBs cut down on paper, for both the forms themselves and the envelopes they’re mailed in. Then there’s the matter of the electricity and ink involved in printing them, the emissions produced in their delivery, etc. Opting to send EoBs via email reduces all these factors, which enables healthcare organizations to lower their carbon footprint and, where applicable, meet their sustainability obligations or goals.

Deliver EoBs More Securely, Reliably, and at Lower Cost with LuxSci

LuxSci’s Secure High Volume Email Solution enables healthcare insurance companies to instantly send Explanation of Benefits statements to policyholders at a massive scale, extending into hundreds of thousands or millions per month.

Our HIPAA compliant email delivery platform features:

  • Dedicated IPs that isolate critical transactional messages, such as EoBs, from other email traffic, allowing LuxSci customers to reach deliverability rates of 98% or more.
  • Real-time tracking for determining the delivery status of EoBs, as well as troubleshooting unsuccessful delivery attempts.
  • Flexible encryption through LuxSci’s proprietary SecureLine Technology, which automatically adjusts encryption settings according to the recipient to better ensure the protection of sensitive data.

Contact us today to learn more about how your organization can begin the transition to electronic EoBs.

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marketing management

What is Marketing Management in the Medical Field?

Marketing management in the medical field involves planning, implementing, and measuring promotional strategies that attract patients while maintaining healthcare regulatory compliance. Medical marketing managers oversee patient outreach campaigns, service promotion, physician relationship development, and digital presence management. They balance business growth objectives with healthcare ethics and industry regulations to build practice reputation and patient relationships.

Strategic Planning for Healthcare Organizations

Medical marketing management begins with developing plans that align with organizational goals. Marketing managers analyze market opportunities by studying local demographics, competition, and healthcare needs. They identify target patient populations based on practice specialties and growth objectives. Service line evaluations determine which medical offerings need promotional support. Resource allocation decisions balance marketing investments across digital platforms, community outreach, and traditional advertising. These plans generally span 12-18 months with quarterly review points to assess progress and make adjustments based on performance data.

Patient Acquisition Campaign Development

Marketing managers design and implement campaigns to attract new patients to medical practices and facilities. They create messaging that communicates practice specialties and physician expertise. Channel selection decisions determine where promotional content appears based on target audience media habits. Campaign development includes creating content, designing materials, and establishing measurement frameworks. Budget management ensures marketing resources deliver maximum patient acquisition results. Marketing managers coordinate with clinical teams to ensure promotional messages accurately represent medical services while meeting patient needs and expectations.

Digital Presence and Reputation Management

Medical marketing management includes overseeing healthcare organizations’ digital footprint across websites, social media, and review platforms. Website optimization ensures patients can find information about services, providers, and locations. Content development provides educational resources that build patient trust and demonstrate expertise. Online review monitoring tracks patient feedback while guiding appropriate responses. Social media management creates engagement with communities while adhering to patient privacy requirements. These digital efforts make practices more visible to potential patients while building credibility through consistent, professional online presence.

Referral Network Development

Medical marketing management build relationships with referring physicians and healthcare partners. They create materials outlining practice specialties and treatment approaches for physician audiences. Educational events connect specialists with primary care providers who might refer patients. Communication systems ensure referring physicians receive appropriate updates about their patients’ care. Data tracking measures referral patterns and identifies opportunities for relationship improvement. These referral development activities create sustainable patient flow while fostering professional connections that benefit patient care coordination.

Regulatory Compliance Oversight

Healthcare marketing requires strict adherence to regulations governing promotional activities. Marketing managers ensure materials comply with HIPAA privacy requirements when using patient information. FDA guidelines influence how treatments and medical devices can be promoted. State regulations may add requirements for certain specialties or services. Review processes include legal and compliance team approval before materials reach the public. Marketing managers stay current on regulatory changes through continuing education and industry associations. This compliance focus protects both patients and healthcare organizations from inappropriate marketing practices.

Performance Analysis and Optimization

Medical marketing managers implement measurement systems to evaluate campaign effectiveness. They track metrics like new patient acquisition costs, appointment conversion rates, and service line growth. Digital analytics measure website traffic, content engagement, and online appointment requests. Patient satisfaction surveys gather feedback about how people found the practice and their experience. ROI calculations demonstrate marketing’s contribution to organizational financial health. These analyses guide ongoing optimization of marketing strategies and tactical adjustments to improve results. Regular reporting to leadership maintains accountability while demonstrating marketing’s value to the organization.

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hands on a keyboard sending secure email

How to Secure SMTP Email Delivery with TLS

Secure email sending is a priority for organizations that communicate sensitive data externally. One of the most common ways to send secure emails is with SMTP TLS. TLS stands for Transport Layer Security and is the successor of SSL (Secure Socket Layer). TLS is one of the standard ways that computers on the internet transmit information over an encrypted channel. In general, when one computer connects to another computer and uses TLS, the following happens:

  1. Computer A connects to Computer B (no security)
  2. Computer B says “Hello” (no security)
  3. Computer A says, “Let’s talk securely over TLS” (no security)
  4. Computers A and B agree on how to do this (secure)
  5. The rest of the conversation is encrypted (secure)

In particular:

  • The conversation is encrypted
  • Computer A can verify the identity of Computer B (by examining its SSL certificate, which is required for this dialog)
  • The conversation cannot be eavesdropped upon (without Computer A knowing)
  • A third party cannot modify the conversation
  • Third parties cannot inject other information into the conversation.

TLS and SSL help make the internet a more secure place. One popular way to use TLS is to secure SMTP to protect the transmission of email messages between servers.

Secure SMTP Email Delivery with TLS 

The mechanism and language by which one email server transmits email messages to another email server is called Simple Mail Transport Protocol, or SMTP. For a long time, email servers have had the option of using TLS to transparently encrypt the message transmission from one server to another.

When available, using TLS with SMTP ensures the message contents are secured during transmission between the servers. Unfortunately, not all servers support TLS! Many email providers, especially free or public ones, have historically not supported TLS. Thankfully, the trend is shifting. LuxSci found that most providers now support TLS- approximately 85% of domains tested as of July 2022.

Using TLS requires that the server administrators:

  1. purchase SSL certificates
  2. configure the email servers to use them (and keep these configurations updated)
  3. allocate additional computational resources on the email servers involved.

For TLS transmission to be used, the destination email server must offer support for TLS, and the sending computer or server must be configured to use TLS connections when possible.

The sending computer or server could be configured for:

  1. No TLS: never use it.
  2. Opportunistic TLS: use it if available; if not, send it insecurely.
  3. Forced TLS: use TLS or do not deliver the email at all.

How Secure is Email Delivery over SMTP TLS?

TLS protects the transmission of the email message contents. It does nothing to protect the security of the message before it is sent or after it arrives at its destination. For that, other encryption mechanisms may be used, such as PGP, S/MIME, or storage in a secure portal.

For sending sensitive information to customers, transmission security is the minimum standard for compliance with healthcare and financial regulations. TLS is appropriate to meet most compliance requirements and offers an excellent alternative to more robust and less user-friendly encryption methods (like PGP and S/MIME).

There are different versions of TLS- 1.0 and 1.1 use older ciphers and are not as secure, while TLS 1.2 and 1.3 use newer ciphers and are more secure. When an email is sent, the level of TLS used is as secure as can be negotiated between the sending and receiving servers. If they both support strong encryption (like AES 256), then that will be used. If not, a weaker grade of encryption may be used. The sending and receiving servers can choose the types of encryption they will support. If there is no overlap in what they support, then TLS will fail (this is rare).

What About Replies to Secure Messages?

Let’s say you send a message to someone that is securely delivered to their inbox over TLS. Then, that person replies to you. Will that reply be secure? This may be important if you are communicating sensitive information. The reply will use TLS only if:

  1. The recipient’s servers support TLS for outbound email (there is no way to test this externally).
  2. The mail servers (where the “From” or “Reply” email address is hosted) support TLS for inbound email.
  3. Both servers support overlapping TLS ciphers and protocols and can agree on a mutually acceptable means of encryption.

Unless familiar with the providers in question, it cannot be assumed that replies will use TLS. So, what should you do? Ultimately, it depends on what compliance standards you must meet, the level of risk you are willing to accept, and the types of communications you send. There are two general approaches to this question:

  1. Conservative. If replies must be secure in all cases, assuming TLS will be used is unreasonable. In this case, a more secure method should be used to encrypt the messages in transit and store them upon arrival. The recipient must log in to a secure portal to view the message and reply securely. Alternatively, PGP or S/MIME could be used for additional security.
  2. Aggressive. In some compliance situations like HIPAA, healthcare providers must ensure that ePHI is sent securely to patients. However, patients are not beholden to HIPAA and can send their information insecurely to anyone they want. If the patient’s reply is insecure, that could be okay. For these reasons, and because using TLS for email security is so easy, many do not worry about the security of email replies. However, this should be a risk factor you consider in an internal security audit. Consider nuanced policies that allow you to send less sensitive messages with TLS while sending more sensitive messages with higher security.

What are the Weaknesses of SMTP TLS?

As discussed, SMTP TLS has been around for a long time and has recently seen a great deal of adoption. However, it has some deficiencies compared to other types of email security:

  • There is no mandatory support for TLS in the email system.
  • A receiver’s support of the SMTP TLS option can be trivially removed by an active man-in-the-middle because TLS certificates are not actively verified.
  • Encryption is not used if any aspect of the TLS negotiation is undecipherable/garbled. It is very easy for a man-in-the-middle to inject garbage into the TLS handshake (which is done in clear text) and have the connection downgraded to plain text (opportunistic TLS) or have the connection fail (forced TLS).
  • Even when SMTP TLS is offered and accepted, the certificate presented during the TLS handshake is usually not checked to see if it is for the expected domain and unexpired. Most MTAs offer self-signed certificates as a pro forma. Thus, in many cases, one has an encrypted channel to an unauthenticated MTA, which can only prevent passive eavesdropping.

The Latest Updates to Secure SMTP TLS

Some solutions help remedy these issues—for example, SMTP Strict Transport Security. SMTP STS enables recipient servers to publish information about their SMTP TLS support in their DNS. This prevents man-in-the-middle downgrades to plain text delivery, ensures more robust TLS protocols are used, and can enable certificate validation.

In addition, users can adopt TLS 1.3. NIST recommends that government agencies develop migration plans to support TLS 1.3 by January 1, 2024. LuxSci supports both SMTP MTA-STS and TLS 1.3.

How Secure SMTP TLS Email Works with LuxSci

Inbound TLS

LuxSci’s inbound email servers support TLS for encrypted inbound email delivery from any sending email provider that also supports that. For selected organizations, LuxSci also locks down its servers to only accept email from them if delivered over TLS.

Outbound Opportunistic TLS

LuxSci’s outbound email servers will always use TLS with any server that claims to support it and with whom we can talk TLS v1.0+ using a strong cipher. The message will not be sent securely if the TLS connection to such a server fails (due to misconfiguration or no security protocols in common). Outbound opportunistic TLS encryption is automatic for all LuxSci customers, even those without SecureLine.

Forced TLS

When Forced TLS is enabled, the message is either dropped or sent with an alternate form of encryption if the recipient’s server does not support TLS. This ensures that messages will never be sent insecurely. Forced TLS is also in place for all LuxSci customers sending to banks and organizations that have requested that we globally enforce TLS to their servers.

Support for strong encryption

LuxSci’s servers will use the strongest encryption supported by the recipient’s email server. LuxSci servers will never employ an encryption cipher that uses less than 128 bits (they will fail to deliver rather than deliver via an excessively weak encryption cipher), and they will never use SSL v2 or SSL v3.

Does LuxSci Have Any Other Special TLS Features?

When using LuxSci SecureLine for outbound email encryption:

  1. SMTP MTA STS: LuxSci’s domains support SMTP MTA STS, and LuxSci’s SecureLine encryption system leverages STS information about recipient domains to improve connection security.
  2. Try TLS: Account administrators can have secure messages “try TLS first” and deliver that way. If TLS is unavailable, the messages would fall back and use more secure options like PGP, S/MIME, or Escrow. Email security is easy, seamless, and automatic when communicating internally or with others who support TLS.
  3. TLS Exclusive: This is a special LuxSci-exclusive TLS sending feature. TLS Exclusive is just like Forced TLS, except that messages that can’t connect over TLS are just dropped. This is ideal for low-importance emails that must still be compliant, like email marketing messages in healthcare. In such cases, the ease of use of TLS is more important than receiving the message.
  4. TLS Only Forwarding: Account administrators can restrict any server-side email forwarding settings in their accounts from allowing forwarding to any email addresses that do not support TLS for email delivery.
  5. Encryption Escalation: Often, TLS is suitable for most messages, but some messages need to be encrypted using something stronger. LuxSci allows users to escalate the encryption from TLS to Escrow with a click (in WebMail) or by entering particular text in the subject line (for messages sent from email programs like Outlook).
  6. Domain Monitoring: When TLS delivery is enabled for SecureLine accounts, messages will never be insecurely sent to domains that purport to be TLS-enabled, i.e., TLS delivery is enforced and no longer “opportunistic.” The system monitors these domains and updates their TLS-compliance status daily.
  7. Double Encryption: Messages sent using SecureLine and PGP or S/MIME will still use Opportunistic TLS whenever possible for message delivery. In these cases, messages are often “double encrypted.” First, they are encrypted with PGP or S/MIME and may be encrypted again during transport using TLS.
  8. No Weak TLS: Unlike many organizations, LuxSci’s TLS support for SMTP and other servers only supports those protocol levels (e.g., TLS v1.0+) and ciphers recommended by NIST for government communications and which are required for HIPAA. So, all communications with LuxSci servers will be over a compliant implementation of TLS.

For customers who can use TLS to meet security or compliance requirements, it enables seamless security and “use of email as usual.” SecureLine with Forced TLS enables clients to take advantage of this level of security whenever possible while automatically falling back to other methods when TLS is unavailable.

Of course, using Forced TLS as the sole method of encryption is optional; if your compliance needs are more substantial, you can turn off TLS-Only delivery or restrict it so that it is used only with specific recipients.

If your email use cases are complicated, LuxSci’s flexibility enables the secure sending of emails to any recipient, regardless of their email service provider’s support for TLS. Contact the LuxSci sales team to learn more about our secure SMTP TLS email sending.

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How to Set Up HIPAA Compliant Email

Why Is Email Deliverability Important?

Email deliverability is important as it directly determines whether healthcare organizations can successfully communicate with patients, providers, and business partners when it matters most. Poor email deliverability can result in missed appointments, delayed care coordination, lost revenue, and compliance violations that put both patient safety and organizational reputation at risk. For healthcare providers, payers, and suppliers, maintaining high email deliverability rates means ensuring that appointment reminders reach patients, lab results arrive on time, and billing communications are received without delay. When deliverability fails, the entire healthcare communication chain breaks down, creating gaps in the patient journey and administrative efficiency.

Email Deliverability Affects Patient Care Coordination

Patient care coordination depends heavily on timely, reliable email communication between healthcare providers, specialists, and patients themselves. When email deliverability rates drop, appointment reminders fail to reach patients, leading to increased no-show rates and delayed care. Lab results that end up in spam folders can delay treatment decisions, while referral communications that never arrive can disrupt the continuity of care between primary physicians and specialists. Healthcare organizations with poor email deliverability face cascading effects throughout their patient care processes. A single missed communication can lead to delayed diagnoses, postponed treatments, and frustrated patients who feel disconnected from their care team. Emergency departments may not receive timely notifications about incoming patients, while discharge instructions delivered via email may never reach patients who need them most. The ripple effects of poor email deliverability extend far beyond simple communication failures, directly impacting patient outcomes and satisfaction scores.

Poor Email Deliverability Creates Revenue Loss

Revenue loss from poor email deliverability affects missed appointments, delayed payments, failed billing communications, and reduced patient engagement with healthcare services. When billing statements and payment reminders fail to reach patients due to deliverability issues, healthcare organizations experience increased accounts receivable aging and higher collection costs. Insurance claim notifications and EOBs that end up in spam folders can delay reimbursement processes, affecting cash flow and financial stability. Healthcare organizations also lose revenue through reduced patient engagement with preventive care services and elective procedures. Email campaigns promoting wellness programs, health screenings, and specialized services generate lower response rates when deliverability problems prevent messages from reaching patient inboxes. The financial impact compounds over time, as organizations invest in email marketing and patient communication tools that fail to deliver expected returns due to underlying email deliverability challenges.

Compliance Risks When Deliverability Fails

Healthcare organizations face large compliance risks when email deliverability problems prevent timely delivery of required communications. HIPAA regulations require covered entities to implement reasonable safeguards for protecting patient information, and failed email delivery can create documentation gaps that expose organizations to regulatory scrutiny. When patient communications fail to reach their intended recipients, or worse, reach an unintended recipient, healthcare organizations compliance lapses and data breaches can occurr. Failed email deliverability can also create audit trail problems, as organizations may not realize that required communications never reached patients or business partners. This lack of visibility into delivery failures can lead to compliance violations that result in fines, penalties, and increased regulatory oversight. Healthcare organizations operating under value-based care contracts face additional risks when poor email deliverability prevents timely communication of quality metrics and performance data to payers and regulatory bodies.

Email Deliverability Impacts Operational Efficiency

Operational efficiency in healthcare depends on smooth communication flows between departments, providers, external partners, and patients and customers. When email deliverability issues disrupt these communication channels, healthcare organizations experience increased administrative burden, duplicated efforts, and workflow interruptions. Staff members spend additional time following up on communications that may have been filtered into spam folders or blocked entirely, reducing productivity and increasing operational costs. Poor email deliverability also affects supply chain management, as communications with vendors, suppliers, and business partners may fail to reach their intended recipients. Order confirmations, shipping notifications, and inventory updates that end up in spam folders can lead to supply shortages, delivery delays, and increased procurement costs. Healthcare organizations may need to implement alternative communication methods, such as phone calls or postal mail, which are more expensive and time-consuming than email.

Technology Integration Challenges

Healthcare organizations rely on integrated technology systems that depend on reliable email deliverability for automated notifications, alerts, and data exchanges. Electronic health record systems, customer data platforms, and patient portal platforms all generate email communications that can be affected by deliverability issues. When these automated systems cannot reliably deliver messages, healthcare organizations may experience system-wide communication breakdowns that affect multiple departments and workflows. Poor email deliverability can also disrupt integration with third-party healthcare applications, telemedicine platforms, and health information exchanges. These systems rely on email notifications to alert providers about new patient data, test results, or system updates. When deliverability problems prevent these notifications from reaching their intended recipients, healthcare organizations may miss important information that affects patient care decisions and operational planning.

Building Sustainable Practices

Healthcare organizations can build sustainable email deliverability practices by implementing authentication protocols, monitoring sender reputation, and maintaining clean recipient lists. Regular audits of email deliverability performance help identify problems before they affect patient care, customer communications, or operational efficiency. Organizations benefit from establishing dedicated resources for managing email deliverability, including staff training on best practices and ongoing monitoring of delivery metrics across different communication channels.

Sustainable email deliverability practices also include developing contingency plans for communication failures, such as alternative contact methods and backup notification systems. Healthcare organizations can reduce their vulnerability to email deliverability issues by diversifying their communication channels while maintaining primary reliance on email for routine communications. This balanced approach helps ensure that patient care and operational efficiency remain intact even when challenges arise.

 

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