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HIPAA-Compliant Electronic Signatures: 2026 Requirements & Checklist

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Keeping patients’ protected health information (PHI) safe is the law for healthcare workers, facilities, and anyone handling patient data. That’s why choosing tools that adhere to the same strict privacy and security standards you do is crucial.

Recently, BoldSign was declared HIPAA- compliant by a third-party auditor. This means organizations subject to HIPAA standards and their partners can confidently use BoldSign to securely obtain electronic signatures for their healthcare-related documents.

Compare the top HIPAA-compliant eSignature platforms 

What is HIPAA?

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 mandates the confidential handling of PHI. This act empowers patients with greater control over their medical records and sets national standards for safeguarding sensitive healthcare information.

HIPAA privacy rules require healthcare providers, organizations, and their business associates to implement procedures that ensure the confidentiality and security of PHI throughout its transfer, receipt, handling, and sharing.

How to Sign a BAA with BoldSign

As a part of HIPAA compliance, those handling HIPAA-protected documents must sign a business associate agreement (BAA) with their electronic signature provider. To get a BAA signed with BoldSign:

  • If you’re an existing BoldSign user, you can contact your dedicated sales manager to get a BAA signed.
  • If you’re an evaluator or someone who just wants to know more about BoldSign’s HIPAA compliance, you can contact our support team or the chat support on the BoldSign website. We are always ready to sign a BAA.

What is a HIPAA violation

An example of what a HIPAA violation might look like when it comes to patient communications, comes from unattended or lost devices. The rise of remote work creates new challenges for organizations subject to HIPAA security requirements. Lost or unattended devices can allow unauthorized access to PHI by family members, friends, or hackers.

BoldSign can help mitigate these risks through features like restricting user profiles with granular roles and permissions.

HIPAA requirements

Here are a few features that make BoldSign a HIPAA compliant electronic signature platform

Robust data security

All electronic data must be encrypted, and any hosting services used by electronic signature providers must also provide a high level of security. In BoldSign, your data is protected by some of the highest security and privacy standards in the industry.

Reliable uptime

Patients require consistent access to their ePHI. BoldSign has an almost 99.99% uptime record. You can track our system status and history from this webpage.

Data location

For HIPAA compliance, data must be stored within the United States region. BoldSign is hosted on the Google Cloud Platform and Microsoft Azure servers in the US East data center.

Access restrictions

BoldSign supports two-factor authentication (2FA) for accessing accounts in secure way and allows IP restriction too to safeguard PHI access.

Business associate agreements (BAA)

All eSignature software providers must be willing to sign a BAA with organizations requiring HIPAA compliance. BoldSign is always ready to sign a BAA

Please keep in mind that adhering to these guidelines alone doesn’t guarantee HIPAA compliance, but these are a few of the main components. Always consult with an expert when implementing new systems.

HIPAA eSignature Checklist

Use this quick checklist to evaluate HIPAA-aligned eSignature solutions:

  • Signs a Business Associate Agreement (BAA)
  • Encrypts PHI in transit and at rest
  • Uses role-based access and multi-factor authentication
  • Maintains tamper-evident audit trails
  • Verifies signer identity
  • Shares signed documents via secure links, not email attachments

Potential limitations with HIPAA compliance

In BoldSign the below things will be restricted once you have signed BAA with us to ensure the HIPAA standards.

  • CCing others: HIPAA compliant solutions do not allow CC’ing other peoples on signature requests in order to prevent unauthorized access to PHI. In BoldSign, once you have enabled HIPAA, the option to enter CC recipients will be automatically disabled.
  • PDF copies: HIPAA compliance prohibits sending signed documents via email to prevent potential breaches. Instead, we send the completed documents as links where only the authorized person can access it.
  • Document titles and messages: These are restricted to contain only minimal information not considered PHI to prevent accidental disclosure. Editing titles or messages could violate HIPAA rules
Do I need a Business Associate Agreement (BAA) with the eSignature provider?

Yes, if the provider stores or transmits PHI. The BAA outlines both parties’ responsibilities in protecting PHI.


What types of documents can be signed electronically with a HIPAA compliant eSignature?

Any document containing PHI, such as consent forms, prescriptions, lab results, etc.


Who can use a HIPAA compliant eSignature?

Healthcare providers, covered entities, and their business associates.


Is eSignature allowed under HIPAA?

Yes, but it must meet specific requirements to be considered HIPAA compliant.


Are electronic signatures HIPAA compliant?

Yes, with safeguards, e-signatures can meet HIPAA standards. BoldSign protects PHI via encryption, U.S. hosting, 2FA, and BAA support—ensuring compliance and legal validity.


What are the requirements for electronic signature in HIPAA?

For HIPAA electronic signatures, covered entities and business associates must verify user identity, ensure data integrity, prevent denial of actions, and maintain audit trails. Secure platforms that detect tampering help protect ePHI.


What are the two main rules of HIPAA?

Privacy Rule: Establishes standards for protecting individually identifiable health information (PHI), ensuring it is not disclosed without consent or legal authorization.

Security Rule: Sets national standards to safeguard electronic PHI (ePHI) through administrative, physical, and technical safeguards.


What is the healthcare policy on electronic signatures?

Electronic signatures in healthcare must comply with HIPAA regulations. They must be secure, legally valid, and capable of protecting patient data—making them as reliable as handwritten signatures when used in healthcare documentation.


Does HIPAA protect all PHI electronic, verbal, and written?

Yes, HIPAA protects all forms of Protected Health Information (PHI), including electronic, verbal, and written formats, under the Privacy Rule. It ensures comprehensive safeguards across every method of communication and storage.

Conclusion

By understanding HIPAA regulations and choosing compliant tools like BoldSign, you can ensure the secure handling of sensitive patient data and your organization’s compliance with the law. If you are still assessing available options, you may want to see our Top 5 HIPAA-compliant eSignature platforms before making a final decision.

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