Best HIPAA-Compliant AI for Therapists: Which Vendors Sign a BAA?

Purpose-built therapy scribes such as Mentalyc, Supanote and Upheal include a BAA, and Claude Enterprise, Google Workspace and the OpenAI API can be covered once an admin accepts one. ChatGPT Business has no BAA, and ChatGPT for Clinicians, which does, admits physicians, nurse practitioners, physician assistants and pharmacists, not therapists.

The wording on a pricing page is not the signed document. Before any client material goes in, you need the actual agreement for your account, the plan it covers and the features it leaves out. That last part catches more practices than the missing contract does.

Follow me on Instagram@sagnikteaches

What a BAA does and what it leaves to you

A business associate agreement is a contract between a healthcare provider covered by HIPAA and a company that handles client health information on its behalf. The company promises to safeguard the data, report breaches and use it only for the service you bought. Without one, pasting a session summary into a tool is a disclosure to a third party that nobody has agreed to protect.

Connect on LinkedInSagnik Bhattacharya

The contract does not make the tool safe by itself. Three things stay with you: the settings you choose, who in your practice has an account, and what you tell clients. Think of the BAA as the entry ticket and the configuration as the actual security work.

Subscribe on YouTube@sagnikteaches

If you are still weighing whether notes should come from a recording or from your own dictation, that is a separate choice covered in recording or dictation style for AI note takers. This tutorial answers the narrower question of who will sign.

The two families of tool and why they differ

Purpose-built scribes were designed for clinical notes. Their sales pages talk about consent forms, note templates and integration with practice software, and a BAA is part of the standard purchase. General assistants such as ChatGPT, Claude and Gemini were built for everyone, so the BAA, where one exists, sits on specific plans and has conditions attached.

Treat the table as a reading list, not a guarantee. Vendors change these pages, and Mentalyc's pricing page, for instance, lists the BAA as a feature but does not say how it is executed for a given account.

ChatGPT, Claude and Gemini one by one

ChatGPT

OpenAI's help article on BAAs says plainly that it does not offer one for ChatGPT Business, the plan a small practice would normally buy for two or more seats. On the ChatGPT side, a BAA comes through sales for Enterprise or Edu accounts, or through ChatGPT for Healthcare, which OpenAI prices on the Enterprise model and offers to hospitals and health systems through its sales team. Separately, the API has a self-serve BAA: an organisation admin accepts it in the API Platform's organisation settings, but only once the organisation has an established history of API usage, and API work with health information also needs Modified Retention. That route matters only if someone is building a tool for you.

ChatGPT for Clinicians is the product that confuses therapists. It is free, sign-up verifies your national provider identifier (NPI) and licence, and an individual can sign a BAA inside the product under Settings, then Agreements. But OpenAI's help page names the eligible clinicians as physicians, nurse practitioners, physician assistants and pharmacists. Psychologists, licensed counsellors, clinical social workers and marriage and family therapists are not on that list, so for most therapists the product is unavailable. A psychiatric nurse practitioner who also provides therapy would qualify as a nurse practitioner. Everyone else should reread the availability paragraph before signing up, because OpenAI may widen the list, and should not assume the word "clinicians" includes them.

Claude

Anthropic's article says Claude Enterprise can be covered when the organisation's Primary Owner activates HIPAA compliance in the settings under Data and privacy and accepts the BAA, and that standard Enterprise plans have no BAA coverage without that step. The article does not mention Team, and Anthropic's pricing page marks only Enterprise as HIPAA-ready. Self-serve Enterprise is listed at $20 a seat a month billed annually plus usage at API rates, with a 20-seat minimum, which puts it out of reach for most solo and small group practices.

Inside a HIPAA-enabled Enterprise organisation, chat, projects in chat, voice and web search are covered. Connectors, MCP servers, skills and Claude in Chrome are available but not covered, and beta features such as Claude Docs and Claude Slides are excluded. So a clinician who asks Claude to save a session summary to Google Drive through a connector has sent client data down a route the agreement does not cover, even though the chat itself was covered.

Gemini and Google Workspace

Google's page says a customer subject to the rules must accept a BAA in the admin console before using client information in the services on its HIPAA-included list. A super administrator finds it under Account settings, then Legal and compliance. The page names the Gmail writing features as covered but does not settle whether the standalone Gemini app is, so check that list for the specific feature before you rely on it. For a solo therapist already on Workspace, this may be the simplest route to a covered general assistant, but it is a drafting helper, not a note-taking system.

Why the plan matters as much as the vendor

Take a solo counsellor on an entry scribe plan. The vendor signs a BAA, but the plan caps notes at 40 a month and she sees 28 clients a week. By the second week she is out of notes. She falls back to pasting rough text into a general chatbot to tidy it. The scribe was compliant. The workaround was not.

That pattern is the real risk with a BAA: the covered tool is slightly too limiting, so people route around it. When you shortlist a vendor, count your monthly sessions against the note limit. Mentalyc's plans cap notes at 40, 100, 160 or 330 a month, and Supanote's Starter plan caps them at 40. A full-time clinician seeing 25 clients a week produces roughly 100 session notes a month, so the cheapest tier will run out quickly.

Retention and training settings that a BAA does not fix

SimplePractice's Note Taker is a good example of why settings matter. Clinicians who switch Note Taker on from 17 June 2026 are opted in by default to SimplePractice keeping a de-identified, de-coupled copy of each transcript after the seven-day review window ends or the note is signed (one passage of its help centre says 16 June). Earlier users stay opted out, anyone can opt out per clinician, per client or per session, and SimplePractice says it does not use the retained transcripts to retrain the underlying model. A BAA can sit alongside that default without contradicting it. Whether you are comfortable with it is your decision, and you can only make it if you go looking.

For any tool, walk through these settings on day one:

1. Is audio kept after the transcript is made, and for how long?
2. Is any transcript, even de-identified, kept to improve the vendor's product, and can you opt out?
3. Can you delete a note or a client's whole history, and does deletion reach backups?
4. Who at the vendor can open a session for support, and is that logged?
5. Are optional integrations (email, calendar, shared workspaces) switched off until you need them?

Record the date you checked each answer. Vendors change defaults, and a dated note is useful if a client or regulator ever asks what you knew.

A request you can send to any vendor

When a pricing page is vague, ask in writing. Keep the message short enough that a support person cannot reply with a marketing link.

Subject: BAA and data handling for [practice name]

Hello,

I'm a solo therapist considering [product] for session notes. Please confirm in writing:

1. Which plan(s) include a signed BAA, and where I accept it.
2. Whether the BAA covers recording, transcription, note generation and any "AI chat" feature.
3. Whether any transcript or audio is kept after the note is created, and how long.
4. Whether my data is used to train or improve any model, and how to opt out.
5. How I delete a client's data completely.

Thanks,
[your name]

A good reply answers all five in plain terms and links the agreement. A reply that says "we take privacy seriously" and nothing else tells you what you need to know.

A worked comparison for a four-clinician practice

Illustration: a four-clinician group practice, each seeing about 22 clients a week, wants AI-drafted notes. Compare three routes on cost and exposure, using list prices read on 4 November 2026.

The built-in route is cheapest on paper, and it keeps notes in one system. The dedicated team plan costs more but usually produces notes in more formats. For the cost angle in more depth, see seat costs for a group practice, and for the built-in option see Note Taker or Care Aide on SimplePractice.

A shadow-AI audit for your own practice

The riskiest AI in a practice is often the one nobody bought. A trainee pastes a case summary into a free chatbot, or a clinician uses a browser extension to tidy notes. Run a ten-minute audit once a quarter.

• Ask every clinician and administrator which AI tools they have opened this month, including phone apps.
• For each, record the plan, whether a BAA exists, and whether client material has ever been entered.
• Write one sentence for each tool: approved, approved for non-client work only, or stopped.

Say a counsellor admits she pastes anonymised vignettes into a free chatbot. If a vignette includes an unusual occupation and a small town, it may not be anonymous at all. The fix is not a lecture. It is to give her an approved scribe or a template workflow so the shortcut is no longer needed.

What to do with tools that have no BAA

General assistants without a BAA are still useful for work that never contains client information. Examples that stay safe:

• Drafting a plain-English explanation of your privacy notice, then editing it yourself.
• Writing a progress-note template with placeholder fields.
• Turning your own marketing copy into a newsletter.
• Brainstorming session-structure ideas for a workshop, with no case detail.

The test is simple. If the text could be printed on your website without harm, it can go in. If it describes a real person's health, it cannot. The same rule is spelled out in can therapists use ChatGPT for session notes.

Telling clients, and the paperwork around it

Some clients accept an AI scribe happily once it is explained, and some will not. Put the tool's name, what it does, whether audio is kept and how a client can say no into your consent form. Keep a plain alternative: you type the note yourself for any client who declines. Suggested wording is in should therapists tell clients they use AI.

Check also whether your professional body or malpractice insurer has said anything about AI scribes. Insurers may ask about it on renewal forms, so keep your answer consistent with your consent form. A qualified adviser who knows your state and professional rules can tell you what applies to you, and this tutorial is not legal advice.

A filled-in scorecard for one candidate

Scoring makes the decision less emotional, especially when a salesperson is friendly. Give each vendor a mark out of two on each line: 2 for a clear written answer, 1 for a vague one, 0 for none. The figures below are an illustration of a scorecard filled in for an imaginary scribe, not a rating of any real product.

That is 7 out of 12, and the two zeros are the real story. A tool that will not answer a training question in writing, or that cannot cover your caseload, is not ready. Set your own pass mark before you start, say 10, so you cannot talk yourself into a lower one later.

Checking an AI draft: a before and after

A BAA protects the data in transit. It does nothing about a wrong note. Here is an illustration of a scribe draft and the edit it needs, with no real client details.

Scribe draft:
Client reports improved sleep and no panic episodes this week. Client stated they
stopped taking medication. Plan: continue weekly CBT, review in four sessions.

What was actually said:
Client reports improved sleep and one short panic episode on Tuesday. Client said
they were thinking about stopping medication and would speak to their prescriber.

Edited note:
Client reports improved sleep and one short panic episode (Tuesday). Client is
considering stopping medication and will discuss with prescriber. Plan: continue
weekly CBT, review in four sessions.

The draft turned a possibility into a fact and dropped an episode. Both errors are clinically significant, and both read smoothly. Make "read every note before signing" a rule, not an aspiration, and treat a draft you approved without reading as the one that gets you into trouble.

Other vendors that need their own agreement

The scribe is rarely the only tool in the chain. Walk through the rest of the path a session takes:

• Video platform. If sessions run on a video tool, its health plan or agreement is separate from the scribe's.
• Email and calendar. Google Workspace needs its own BAA acceptance, as above. Free consumer email has none.
• Cloud storage and backups. Exports from the scribe often land in a folder somewhere.
• Automation tools. A Zap or workflow that forwards a note to a spreadsheet makes the automation vendor a handler of client data.
• Transcription services you used before. Old accounts with uploaded recordings count too.

For a quick confidentiality list covering this path, the confidentiality checklist for AI note tools goes further than this tutorial does.

If something goes wrong: a one-page incident plan

Write the plan while nothing has happened. It should fit on one page:

1. Who you call first (the vendor's security contact, found in advance).
2. How to revoke access: which accounts to lock, which integrations to disconnect.
3. Where the signed BAA and settings screenshots are stored.
4. Who decides whether clients must be told, and the adviser you ask.
5. A log template: date, what happened, what data, what you did.

Practices that keep this page, even for a solo clinician, make decisions faster and calmer when a login is compromised or a clinician mistakenly uploads a recording to the wrong tool.

Reading a trial period sensibly

A 14-day trial is short, so plan it. In week one, run three invented sessions with a colleague playing the client, one with a heavy accent or background noise, one with a couple, one with a long silence. Compare the three notes with your own memory. In week two, switch on the settings from the checklist above and confirm the deletion button actually deletes. Decide on the last day, not the first, and put the decision date in your diary at the start so the trial does not roll into a paid month by default.

How to check the choice worked after 30 days

1. Sample five notes and compare them with what happened in the session. Note any invented details.
2. Time yourself: minutes per note before and after. If the saving is under two minutes, the tool is not worth the risk.
3. Confirm nobody has used a different, uncovered tool alongside it.
4. Re-read the agreement and settings pages for changes.

If you would rather map this with someone, that is what my AI implementation consultation covers. Otherwise, start with the vendor email above. Mentalyc and Supanote both advertise a 14-day trial, enough to test two scribes across a real week, as long as you use made-up practice sessions until the agreement is in place.

Questions therapists ask before signing a BAA

Is a signed BAA enough to make an AI tool safe to use?

No. A BAA is a contract that makes the vendor accountable for protecting client information. You still need to configure the tool correctly, limit who has access, switch off optional data sharing and keep your own consent and retention policies. It is necessary, not sufficient.

Can I use a free AI chatbot if I remove client names?

Removing a name does not always de-identify a session. Dates, places, jobs and family details can still point to one person. Without a BAA, the safe habit is to keep session content out of general chatbots altogether and use them only for generic work such as templates.

Do I need a BAA with every tool that touches client information?

You need one with any vendor that creates, receives, stores or sends client health information for you. That usually includes your scribe, practice software, email host, video platform and cloud storage. A tool you only use for non-client work does not need one.

Who signs the BAA, me or my group practice?

The covered entity signs it. A solo therapist signs for their own practice, while a group practice signs once for the organisation, often through a custom or team agreement. Employed clinicians should not click through individual terms for tools their employer has not approved.

Further reads

• What Does an AI Scribe for Therapists Cost a Solo Practice? — What a covered scribe costs a solo practice each month.
• Automated Booking Systems for Therapists: Which Ones Automate What? — Booking tools also handle client data; check them next.
• How Physiotherapists Use AI to Write Treatment Notes Faster — How a neighbouring profession handles AI-drafted notes.
• Therapy Practice Management Software: What the AI Add-Ons Cost — What the built-in AI add-ons in practice software cost.
• Blueprint AI for Therapists: Notes, Cost and Alternatives to Check — One named scribe and its alternatives to check.
• AI Scribe for Occupational Therapists: A Buyer's Checklist — A buyer's checklist written for occupational therapists.
• Best AI Scribe for Physical Therapy: Four Tools Compared — Four AI scribes for a physical therapy practice compared on per-clinician cost, BAA, treatment-note fit and timed-billing detail, with examples.
• HIPAA-Compliant AI Assistants for a Medical Office: BAA by Plan — Which plan of ChatGPT, Claude, Gemini and Copilot can carry a BAA for a small practice, what each excludes, and a tracker to record it.
• Starting a Speech Therapy Private Practice: AI and the Admin Stack — The five admin systems a new speech therapy practice needs, which parts AI can draft, what each costs, and the order to build them for your first 30 clients.
• What Does AI Cost a Speech Therapy Practice? Three Budget Levels — Three monthly budgets for a speech therapy practice, from a free stack to a four-clinician clinic, with what each covers and what stays manual.
• What's the Best AI Tool for Therapists? A Rule by Practice Size — A rule for choosing a therapy AI tool by practice size, with list prices, BAA checks and worked costs for a solo, three-clinician and nine-clinician practice.
• ABA Session Notes With AI: From Raw Session Data to a Draft Note — A practice-owner workflow for turning trial data into a draft ABA note: de-identify or use a BAA tool, a prompt, a worked example and sign-off.
• AI Tools for Psychotherapists: Diary, Invoices and Referral Replies — An admin-only AI set-up for a therapy practice: diary, invoice wording and referral replies, with no session content anywhere near it.
• AI for Nurse Practitioners: Prior-Auth Letters and Practice Policies — Prior-auth letters, patient messages and policy drafts for an NP-owned practice, with a clear line on what needs a signed BAA.
• AI for Psych Providers: Telehealth Consent Forms and Reminders — Draft a telehealth consent form with AI as a first draft, then run it through named clinician and legal review steps before use.
• AI in Skilled Nursing Facilities: Screening Hospital Referral Packets — A practical packet-screening queue, evidence checklist and human decision gate for skilled nursing admissions teams.
• AI Tools and AI Development: The Complete 2026 Guide — the AI hub, including every tutorial in the AI-for-business series.

Sources: OpenAI Help Center articles on API BAAs, HIPAA-eligible products, ChatGPT for Clinicians and ChatGPT for Healthcare; Anthropic privacy centre BAA article and Claude pricing page; Google Workspace HIPAA compliance page; Mentalyc, Supanote and SimplePractice pricing pages; Upheal and SimplePractice help centres (read 4 November 2026).