How to Secure SMTP Email Delivery with TLS

Business Solutions, HIPAA Compliant Email, HIPAA Email Marketing
Erik Kangas
August 29, 2023

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:

Computer A connects to Computer B (no security)
Computer B says “Hello” (no security)
Computer A says, “Let’s talk securely over TLS” (no security)
Computers A and B agree on how to do this (secure)
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:

purchase SSL certificates
configure the email servers to use them (and keep these configurations updated)
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:

No TLS: never use it.
Opportunistic TLS: use it if available; if not, send it insecurely.
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:

The recipient’s servers support TLS for outbound email (there is no way to test this externally).
The mail servers (where the “From” or “Reply” email address is hosted) support TLS for inbound email.
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:

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.
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:

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.
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.
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.
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.
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).
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.
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.
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.

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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LuxSci Earns 19 G2 Spring 2026 Badges

March 23, 2026
Pete Wermter

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.

Traditional MFA No Longer Qualifies as “Reasonable” Security

March 17, 2026
Pete Wermter

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.

Encryption Optional Email Will Fail Audits in 2026 and Beyond

February 24, 2026
Pete Wermter

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.

LuxSci and Oiva Health Combine to Form Transatlantic Healthcare Communications Group

February 12, 2026
Pete Wermter

Boston & Helsinki, February 12, 2026 – LuxSci, a provider of secure healthcare communications solutions in the United States, and Oiva Health, a Nordic provider of Digital Care solutions in social and healthcare services, today announced that the companies are joining forces. Backed by Main Capital Partners (“Main”), the combination brings together two complementary platforms and teams, forming a strong transatlantic software group focused on secure healthcare communications.

Founded in 1999, LuxSci is a U.S. provider of HIPAA‑compliant, secure email, marketing, and forms solutions. Its application and infrastructure software enable organizations to securely deliver personalized, sensitive data at scale to support a broad range of healthcare communications and workflows including care coordination, benefits and payments, marketing, wellness communications, after care and ongoing care. Certified by HITRUST for the highest levels of data security, LuxSci serves dozens of healthcare enterprises and hundreds of mid‑market organizations.

Founded in 2010, Oiva Health is a provider of digital care and communications solutions in the Nordics. Headquartered in Finland, with additional offices in Denmark, Norway, and Sweden, Oiva Health offers digital care and digital clinic solutions – including digital visits, secure messaging, online scheduling and appointments, and caregiver communications – serving the long-term care, especially elderly care, and occupational healthcare verticals. The company employs approximately 60 people and has recently expanded across the Nordic region, with a growing presence in Norway and Sweden.

The combination of LuxSci and Oiva Health creates a larger, cross Atlantic group with complementary solutions, serving the U.S. and European markets. Together, the companies offer healthcare providers, payers, and suppliers a comprehensive suite of tools to communicate securely and compliantly, spanning communications, workflows, and virtual care delivery.

Daan Visscher, Partner and Co-Head North America at Main, commented: “We are pleased to announce this cross Atlantic transaction, creating an internationally active secure communications player within the healthcare and home care space. The combined product suite enables healthcare organizations to drive much needed efficiency gains in healthcare provision addressing a global trend of rising costs, aging population, and increasing pressure on resources needed to provide high-quality care.”

Mark Leonard, CEO of LuxSci, said, “We are thrilled to join forces with Oiva Health and believe that together we can truly make a difference in healthcare coordination, access, and delivery. We see an exciting path forward with our customers benefiting from an end-to-end, secure and compliant approach to optimizing both healthcare communications and today’s frontline workers, which we need now more than ever.”

Juhana Ojala, CEO at Oiva Health, concluded, “We look forward to this new chapter together with LuxSci. We are very excited about the strong alignment between our solutions, which especially strongly positions us to expand our flagship Digital Care offering to the high-potential U.S. care market – from care coordination to care delivery to in-home and institutional care.”

Nothing contained in this Press Release is intended to project, predict, guarantee, or forecast the future performance of any investment. This Press Release is for information purposes only and is not investment advice or an offer to buy or sell any securities or to invest in any funds or other investment vehicles managed by Main Capital Partners or any other person.

[END OF MESSAGE]

About LuxSci

LuxSci is a U.S.-based provider of secure healthcare communications solutions for the healthcare industry. The company offers secure email, marketing, forms and hosting, delivering HIPAA‑compliant communication solutions that enable organizations to safely manage and transmit sensitive data. Founded in 1999, LuxSci serves more than 1,900 customers across healthcare verticals, including providers, payers, suppliers, and healthcare retail, home care providers, and healthcare systems, as well as organizations operating in other highly regulated industries. LuxSci is HITRUST‑certified with example clients being Athenahealth, 1800 Contacts, Lucerna Health, Eurofins, and Rotech Healthcare, among others.

About Oiva Health

Oiva Health is a Digital Care provider in the Nordics, offering a comprehensive Digital Platform for integrated health and care services to digitalize primary healthcare, social care, hospital healthcare and long-term care services. The company was founded in 2010 and currently employs approximately 60 people in Finland, Denmark, Norway, and Sweden serving domestic municipalities, customers and partners, such as City of Helsinki, Keski-Suomi Welfare Region, Länsi-Uusimaa Welfare Region in Finland, and Viborg municipality in Denmark with its Digital Care platform. Annually over 5 million customer contacts are handled digitally through Oiva Health’s Digital Care and Digital Clinic platforms.

About Main Capital Partners

Main Capital Partners is a software investor managing private equity funds active in the Benelux, DACH, the Nordics, France, and the United States with approximately EUR 7 billion in assets under management. Main has over 20 years of experience in strengthening software companies and works closely with the management teams across its portfolio as a strategic partner to achieve profitable growth and create larger outstanding software groups. Main has approximately 95 employees operating out of its offices in The Hague, Düsseldorf, Stockholm, Antwerp, Paris, and an affiliate office in Boston. Main maintains an active portfolio of over 50 software companies. The underlying portfolio employs approximately 15,000 employees. Through its Main Social Institute, Main supports students with grants and scholarships to study IT and Computer Science at Technical Universities and Universities of Applied Sciences.

The sender of this press release is Main Capital Partners.

For more information, please contact:

Main Capital Partners
Sophia Hengelbrok (PR & Communications Specialist)

sophia.hengelbrok@main.nl

+ 31 6 53 70 76 86

What Is HIPAA For Explanation Of Benefits Statements?

June 6, 2025
Erik Kangas

HIPAA for explanation of benefits statements includes privacy protections, disclosure limitations, and patient access rights that healthcare providers, payers, and suppliers need to understand when handling these documents. These requirements govern how explanation of benefits forms can be shared, stored, and transmitted while protecting patient information. Healthcare organizations processing explanation of benefits communications encounter specific HIPAA obligations that affect billing workflows, patient communications, and third-party interactions.

Privacy Protections in Explanation of Benefits Communications

HIPAA for explanation of benefits statements requires health plans to protect patient information contained within these documents. Explanation of benefits forms contain protected health information including patient names, dates of service, provider details, and treatment codes that qualify for privacy protections under HIPAA regulations. Health insurers processing explanation of benefits must implement safeguards to prevent unauthorized access, use, or disclosure of this information during document creation, transmission, and storage processes. The privacy protections extend to electronic and paper-based explanation of benefits communications. Health plans sending explanation of benefits via email need encryption or secure patient portals to protect information during transmission. When mailing paper explanation of benefits, insurers must use appropriate addressing and packaging to prevent accidental disclosure to unintended recipients. Correct implementation of these privacy measures prevents unauthorized access and maintains patient confidentiality.

Patient Access Rights for Explanation of Benefits Documents

Patients have specific rights under HIPAA regarding their explanation of benefits statements, including the right to receive copies, request corrections, and control how these documents are shared. Health plans must provide explanation of benefits to patients within reasonable timeframes and allow patients to designate how they prefer to receive these communications. Patients can request explanation of benefits in specific formats or ask that copies be sent to alternative addresses when medically necessary or for safety reasons. The right to request amendments applies to explanation of benefits when patients identify errors in treatment descriptions, billing codes, or other information contained within these documents. Health plans must have procedures for handling amendment requests and responding to patients within required timeframes. When approved, health plans must accommodate these requests according to HIPAA timelines and notification procedures.

Disclosure Rules for Explanation of Benefits Information

Health plans must follow certain disclosure rules when sharing explanation of benefits information with healthcare providers, patients, and third parties. HIPAA allows disclosure of explanation of benefits information for treatment, payment, and healthcare operations without patient authorization, but requires minimum necessary standards to limit information sharing to what is needed for the specific purpose. Healthcare providers can receive explanation of benefits details related to their patients’ claims processing and payment status as part of routine payment operations. Disclosure to family members or personal representatives requires either patient authorization or demonstration that the person has legal authority to act on the patient’s behalf. Health plans cannot share explanation of benefits information with employers, even when the employer sponsors the health plan, without specific patient authorization or as permitted under limited circumstances outlined in HIPAA regulations. Patient privacy remains protected while enabling health plans to conduct necessary payment and administrative activities.

Electronic Transmission Requirements for Explanation of Benefits

Electronic transmission of explanation of benefits requires compliance with HIPAA security standards to protect patient information during digital communication processes. Health plans using email, patient portals, or other electronic methods to deliver explanation of benefits must implement appropriate safeguards including encryption, access controls, and transmission security measures. These requirements apply whether explanation of benefits are sent as attachments, embedded in secure messages, or accessed through online platforms. The security requirements also cover explanation of benefits data stored in electronic systems, requiring health plans to implement administrative, physical, and technical safeguards to protect this information from unauthorized access or disclosure. Audit controls help track who accesses explanation of benefits information and when, providing accountability and helping identify potential security incidents. Organizations benefit from conducting periodic reviews to address emerging security challenges and technology updates.

Business Associate Obligations for Explanation of Benefits Processing

Third-party vendors processing explanation of benefits on behalf of health plans operate as business associates under HIPAA and must comply with specific obligations when handling this protected health information. Business associate agreements must outline how vendors will protect explanation of benefits data, limit its use to authorized purposes, and report any security incidents or unauthorized disclosures. These agreements help ensure that outsourced explanation of benefits processing maintains the same privacy and security protections required of health plans. Business associates processing explanation of benefits must implement appropriate safeguards for the information they handle and ensure that any subcontractors also comply with HIPAA requirements. The obligations include limiting access to explanation of benefits information to authorized personnel, providing security training, and maintaining audit logs of information access and use. Proper contract management and oversight ensure that all parties handling explanation of benefits information maintain appropriate privacy standards.

Compliance Monitoring for Explanation of Benefits Practices

Healthcare organizations need to consistently assess their explanation of benefits practices to ensure continued HIPAA compliance. Conducting audits also helps to identify potential gaps in privacy protections, disclosure practices, or security measures that could lead to violations. Training programs help staff understand their responsibilities when handling explanation of benefits information and keep them updated on regulatory changes that affect these communications. Incident response procedures specifically address explanation of benefits-related security breaches or privacy violations, including notification requirements and remediation steps. Documentation of explanation of benefits practices, policies, and training helps demonstrate compliance efforts during regulatory reviews or investigations. Consistent monitoring and documentation create a foundation for sustainable HIPAA compliance across all explanation of benefits operations..

What is Marketing Management in the Medical Field?

November 18, 2024
Erik Kangas

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.

Overcoming Barriers To Successful Digital Health Engagement

March 24, 2025
Pete Wermter

Effective patient engagement is increasingly becoming a top priority for many healthcare organizations – and for good reason.

First and foremost, the more a patient or customer is engaged in their healthcare journey, the better their health outcomes and quality of life. With increased communication and engagement, patients are more likely to have potential conditions diagnosed sooner, take preventative measures to prevent illnesses, and educate themselves on ways to manage and improve their health.

However, the benefits don’t end there and aren’t restricted to the patient. Engaged patients pay bills faster, are more open to new products and services, and report higher levels of satisfaction with the companies that contribute to their health and well being. For healthcare providers, payers, and suppliers, this results in higher revenue, more opportunities for growth, and the attainment of long-term organizational goals.

Digital Patient Engagement Is Easier than Ever

Fortunately, advances in technology and their rapid adoption by patients and customers (expedited by the COVID-19 pandemic) have made it easier for healthcare organizations to achieve successful digital interactions and engagement. Healthcare companies have more tools and channels than ever before to help conduct personalized engagement campaigns that meet patients on their terms, making it easier to capture their attention. Secure email takes it even further with the ability to include protected health information in messages to personalize

Despite these advancements, however, there are still several barriers that prevent healthcare companies from engaging with patients and reaping the associated benefits. Fortunately, each barrier can be overcome to help patients and customers feel more included and instrumental in their healthcare journeys.

With this in mind, this post discusses the main barriers to digital patient engagement and how to overcome them to drive better healthcare outcomes for your patients and growth for your organization.

The Main Barriers To Digital Health Engagement

The four key barriers to digital health engagement that we’ll explore in this post are as follows:

1. Low Health Literacy

1. Privacy And Security Concerns

1. Age And Cultural Differences

1. Lack Of Personalization

Let’s review each barrier in turn, while offering potential solutions that will contribute to greater digital health patient engagement for your healthcare organization.

Low Health Literacy

The first barrier to successful digital health patient engagement is your patients having insufficient health or medical knowledge. Healthcare is laden with terminology, including medical conditions, pharmaceuticals, the human anatomy, and many patients simply don’t understand enough to get more involved with their healthcare journey. Worse still, few patients will admit they don’t understand, as people are often embarrassed at their lack of knowledge.

Consequently, if your digital health patient engagement campaigns are heavy with medical jargon and lack personalization, patients won’t act on the information to drive better outcomes.

Solution: Create Educational Health Content

Develop simple educational resources for your patients that apply to their unique needs and condition. This will help them understand their state of health and make better sense of subsequent communications they’ll receive from you and their other healthcare providers.

This educational content could be in the form of periodic email newsletters, giving you a great reason to keep in touch with your patients. Alternatively, they could take the form of blog posts or articles on a patient portal, which could be supported by an email marketing campaign to let patients know about the article. In helping to increase your patients’ health literacy, you offer additional value as a healthcare provider, payer or supplier.

Additionally, keep the medical jargon in your email communications and other patient engagement channels to a minimum. Empathize with the fact that some patients won’t understand as much as others when it comes to healthcare provision and explain things as plainly as possible.

Data Privacy And Security Concerns

Unfortunately, due to its sensitivity and critical nature patient data, i.e., protected health information (PHI) is highly prized by cybercriminals. Subsequently, there have been many high-profile healthcare breaches, such as the Change Healthcare breach, in early 2024, which affected 100 million individuals, that make patients increasingly wary about sharing health-related information via email, text, or other digital communication channels.

That said, their wary attitude is the right one to adopt, but not at the expense of enhancing engagement and improving their health outcomes.

Solution: Invest In HIPAA Compliant Communication Tools

Ensure that the digital tools you use to engage with patients possess the security features required for HIPAA compliance. The Health Insurance Portability and Accountability Act (HIPAA) provides a series of guidelines that healthcare organizations must comply with to best safeguard PHI. Consequently, solutions that promote their commitment to HIPAA compliance, such as LuxSci, will understand the privacy, security, and regulatory needs of healthcare companies and have developed their tools accordingly.

Most importantly, a HIPAA compliant vendor will sign a Business Associates Agreement (BAA), the legal documentation that outlines your respective responsibilities regarding the protection of PHI. Safe in the knowledge that the patient data under your care is secure, you can concentrate your efforts on personalizing your digital communication campaigns for maximum effect.

Age And Cultural Differences

Ineffective patient engagement efforts (or a complete lack of engagement, altogether) can reinforce cliches about the use of digital tools within particular patient groups. The reality, however, is that many healthcare organizations don’t account for age differences and channel preferences in their patient engagement strategies.

Subsequently, if you only engage with patients on a single communication channel, you risk alienating others because it’s not their medium of choice.

Solution: Adopt a Multi-Channel Engagement Strategy

Instead of focusing on one communication medium, diversify your approach and adopt a multi-channel engagement strategy. This could encompass email, SMS, and phone outreach, for instance. This covers the more proverbial bases and gives you a chance to engage with patients on their preferred terms.

Lack Of Personalization

One of the main reasons that healthcare organizations fail to engage with their patients is that they adopt a “one-size-fits-all” approach, attempting to craft communications that appeal to as many people as possible. Unfortunately, this has the opposite of the desired approach, not connecting anyone in particular and engaging few patients as a result.

Solution: Personalize Your Patient Engagement Campaigns with PHI

With a HIPAA compliant solution, you can use PHI to personalize patient engagement, leveraging their health data to craft messaging that reflects their specific condition, needs, and where they are along their healthcare journey. PHI also can be used to segment patients into subgroups, grouping them by specific commonalities such as age, gender, health condition, and lifestyle factors.

Successful Digital Health Patient Engagement with LuxSci

With more than 20 years of experience in delivering secure digital healthcare communication solutions to some of the world’s leading healthcare providers, payers and suppliers, LuxSci is a trusted partner for organizations looking to boost their patient engagement efforts, while protecting patient data and remaining compliant at all times.

LuxSci’s suite of HIPAA compliant solutions include:

- Secure Email: HIPAA compliant email solutions for executing highly scalable, high volume email campaigns that include PHI – millions of emails per month.

- Secure Forms: Securely and efficiently collect and store ePHI without compromising security or compliance – for onboarding new patients and customers and gathering intelligence for personalization.

- Secure Marketing: proactively reach your patients and customers with HIPAA compliant email marketing campaigns for increased engagement, lead generation and sales.

- Secure Text Messaging: enable access to ePHI and other sensitive information directly to mobile devices via regular SMS text messages.

Interested in discovering more about LuxSci can help you upgrade your cybersecurity posture for PHI and ensure HIPAA compliance? Contact us today!

How To Create a Healthcare Marketing Plan?

August 4, 2025
Erik Kangas

A healthcare marketing plan establishes strategic promotional activities, target audience identification, budget allocation, and compliance protocols to attract new patients while adhering to HIPAA privacy regulations and state advertising laws. Medical practices develop these documents to guide their promotional efforts across digital platforms, traditional media, and community outreach programs, ensuring all patient acquisition activities comply with healthcare privacy requirements and professional advertising standards.

Medical practices compete intensely for patient attention in saturated healthcare markets. Developing promotional strategies without proper planning leads to wasted resources, compliance violations, and missed opportunities to connect with patients who need specific medical services.

Target Audience in Healthcare Marketing Plan Development

Patient demographic research identifies age groups, geographic locations, insurance coverage types, and medical conditions that align with practice specialties and service offerings. Healthcare organizations analyze existing patient data to understand referral patterns, appointment scheduling preferences, and communication channel effectiveness for different population segments.

Competitor analysis reveals promotional strategies used by similar practices, pricing structures for comparable services, and market gaps that create opportunities for differentiation. This research helps practices position their services uniquely while avoiding oversaturated promotional approaches that fail to generate meaningful patient engagement.

Budget Allocation

Financial planning allocates resources across promotional channels based on expected return on investment, patient acquisition costs, and practice revenue goals. Digital advertising usually receives 40-60% of promotional budgets due to measurable results and targeted audience capabilities, while traditional media and community events receive smaller allocations.

Compliance costs including legal reviews, authorization management, and privacy training must be factored into promotional budgets to ensure all activities meet regulatory requirements. Practices that underestimate compliance expenses often discover their promotional activities violate privacy laws or professional advertising standards.

Digital Strategy to Drive Modern Patient Acquisition

Website optimization, search engine marketing, and social media presence are the core of contemporary promotional efforts outlined in every healthcare marketing plan. Practices invest in professional website design, patient portal integration, and mobile-responsive layouts to capture patients researching medical services online.

Content creation including blog posts, educational videos, and patient resources helps establish expertise while providing valuable information to potential patients. However, all content must avoid using patient information without authorization and cannot make unsubstantiated medical claims that violate advertising regulations.

Compliance Integration Protects Promotional Activities

HIPAA authorization procedures, business associate agreements with promotional vendors, and state advertising law compliance must be woven throughout every aspect of promotional planning. Healthcare marketing plan development includes legal review processes, privacy impact assessments, and staff training protocols to prevent violations.

Documentation requirements for promotional activities include consent forms, vendor contracts, and approval workflows that demonstrate compliance with healthcare privacy laws. Practices without proper documentation face significant penalties when regulatory investigations uncover promotional activities that violate patient privacy protections.

Community Outreach Builds Local Patient Relationships

Health fairs, educational seminars, and community partnerships create opportunities for practices to connect with potential patients through face-to-face interactions. These activities require planning to ensure patient privacy protection while maximizing promotional impact through relationship building and trust development.

Referral programs with other healthcare providers, local businesses, and community organizations can generate new patient leads when structured appropriately. Any financial incentives for referrals must comply with healthcare fraud and abuse laws to avoid legal complications.

Performance Measurement Guides Strategy Optimization

Patient acquisition metrics, appointment conversion rates, and promotional channel effectiveness data help practices evaluate their promotional success and adjust strategies accordingly. Healthcare marketing plan implementation includes tracking systems for website traffic, phone inquiries, and new patient appointments generated by different promotional activities.

Return on investment calculations compare promotional spending with revenue generated from new patients to determine which activities provide the best financial results. Practices use this data to reallocate budgets toward high-performing promotional channels while eliminating ineffective strategies.

Implementation Timeline

Monthly promotional calendars coordinate campaign launches, content publication schedules, and community event participation to maximize promotional impact while avoiding resource conflicts. Healthcare marketing plan execution requires detailed project management to ensure all activities launch on schedule and within budget constraints. Seasonal considerations including flu shot campaigns, wellness check promotions, and holiday health messaging opportunities require advance planning to capitalize on increased patient interest during specific time periods. Practices that plan these campaigns well in advance may achieve better results than those that react to opportunities without preparation.