HIPAA-Compliant AI Notetakers for Healthcare (2026)

The short answer: a handful of AI meeting assistants will sign a Business Associate Agreement, almost always on an Enterprise-tier plan: Hedy (Enterprise, 200-seat minimum), Fellow, Fireflies.ai, Read.ai, Circleback, Krisp, Granola and Avoma, plus the BAAs that come with Zoom, Microsoft Teams and Google Workspace. Free and standard plans don’t carry one. Hedy is our top pick for healthcare organizations large enough for Enterprise, because speech recognition runs on the device and Local AI can keep the rest of the pipeline off servers too.

This guide is the explainer: what a BAA has to cover, what each tool’s plan tier actually gives you, and how consent fits in. For the ranked shortlist, see our best HIPAA-compliant AI meeting assistants. This guide covers meeting assistants, not clinical scribes that write notes into an EHR.

What “HIPAA-compliant” requires from a tool

There is no government certification that stamps a software product “HIPAA-compliant.” The phrase is shorthand for conditions a covered entity has to verify itself. For an AI meeting assistant that touches patient conversations, five things matter:

A signed Business Associate Agreement (BAA). This is the contract that makes the vendor legally responsible for safeguarding PHI. Without it, you cannot route patient information through the tool, however good its encryption is.

Encryption in transit and at rest. Audio and transcripts protected with current standards both on the network and in storage.

Configurable retention. Control over how long recordings and notes live, and the ability to delete them.

Audit controls. Logs that show who accessed what, and when.

No training on your data. Ideally the vendor commits contractually that patient conversations never improve its models.

Check that the BAA covers the AI features specifically, not just the base product. “We take security seriously” is not a BAA. If a vendor won’t put its obligations in writing, the conversation is over.

BAA availability, tool by tool

The table uses each vendor’s published terms as we last re-checked them on 14 October 2026. Plan names matter: the BAA almost never comes with the plan most people sign up for.

Why on-device is the safest default for patient conversations

There is a meaningful difference between a tool that handles PHI carefully in the cloud and one where the PHI doesn’t have to leave the room. For consultations, intake interviews and clinical case discussions, keeping processing on the device means there is no vendor-side transcript store to breach, subpoena or misconfigure.

This is the core of why Hedy leads our privacy guide. Its speech recognition always runs on the device, and with Local AI on supported hardware the summaries and notes do too. On the Enterprise plan (200-seat minimum), Hedy signs a BAA, can enforce Local AI on every device, and can keep any cloud data in a Google Cloud project the customer owns. Across plans it offers EU or US data residency, AES-256 encryption at rest with TLS 1.3 in transit, and contractual terms that bar its AI providers from training on customer data. It completed a SOC 2 Type I examination in April 2026 and has completed a HIPAA Business Associate assessment; neither is a certification of HIPAA compliance, which does not exist.

For a health system or large clinical group, that combination is hard to beat: real AI summaries and action items without sending every patient conversation to a third party. The limit is size. Under 200 seats there is no Hedy BAA, so smaller organizations should use one of the cloud tools above with a signed BAA, or keep PHI out of the notetaker.

Patients are a different case. A patient recording their own appointment isn’t a covered entity, so no BAA is involved, and Hedy’s patient-side use is about remembering and understanding what the doctor said: questions to ask in the moment, a summary to reread at home. It is not built for clinician-side documentation, and you should still ask the clinician before recording.

The cloud options

Fellow is the strongest cloud option for clinical teams that need shared notes and meeting management. Its BAA is on Enterprise, it holds a SOC 2 Type II report, it states it never trains on customer data, and it provides transcript redaction. Note that Fellow’s entry price ($7 per user per month) does not include the BAA.

Zoom AI Companion falls under Zoom’s BAA and Zoom says it doesn’t train on customer content. If your practice already runs telehealth on Zoom under a healthcare agreement, enabling AI Companion under the same agreement is the path of least resistance, provided you confirm the BAA covers the AI features. Microsoft Teams Copilot and Google’s Take notes for me work the same way for Teams and Workspace shops.

Fireflies.ai, Read.ai, Circleback and Krisp all put HIPAA support on their Enterprise plans. Fireflies and Circleback state they don’t train on customer data, Read.ai doesn’t by default but runs an opt-out product-evaluation program, and Krisp doesn’t publish a clear training statement. All of them process in the cloud, so confirm the signed BAA before relying on any of them.

Plaud.ai lists SOC 2 Type II, ISO 27001 and 27701, HIPAA and GDPR in its Trust Center but does not publish which plan carries a BAA, so confirm that before recording patients. As a hardware recorder it suits in-person clinical settings where a clinician wants a dedicated capture device.

Check any tool not on this list directly with the vendor. We list only what each vendor publishes.

What to keep away from PHI

Several popular notetakers are good products that are not built for protected health information. Otter.ai offers HIPAA only as an Enterprise add-on and trains on de-identified data by default, with no self-serve opt-out documented. Granola offers a BAA only on Enterprise and trains on de-identified data by default (you can opt out in Settings; only Enterprise has it off from the start). Notta does not sign BAAs and lists “no AI training” only as an Enterprise feature. None of these should touch a patient conversation on a free or standard plan.

The pattern: the free or standard tier is where training-on-by-default and missing BAAs are most common. Larger practices evaluating enterprise contracts have more room; see our enterprise picks.

Consent is a separate obligation

Picking a compliant tool does not discharge your duty to get consent. Recording laws vary by state, and some states require every party to consent before a conversation is recorded. Telehealth sessions add a layer, since participants may be in different states. The BAA governs how the vendor handles the data; it says nothing about whether you were allowed to capture the conversation.

The practical rule: obtain and document consent before any session is recorded, and confirm the rule for the state each participant is in. Write the consent language into your intake paperwork and scheduling confirmation so it is captured the same way every time.

Where this leaves you

For a healthcare organization large enough for an enterprise contract, the cleanest answer is a tool that processes on-device and signs a BAA, which today points to Hedy Enterprise. For a clinical team that needs shared cloud notes with redaction, Fellow is the most complete option, and a Zoom-, Microsoft- or Google-standardized practice can extend its existing BAA to the platform assistant. Whatever you choose, verify the BAA in writing, confirm it covers the AI features, and pair it with a documented consent step. For GDPR rather than HIPAA, see the GDPR guide.