Twofold AI Medical Scribe for Clinicians: Trial Checklist and Cost

Twofold's AI medical scribe can suit a small clinic that wants a low-cost tool working beside any record system: it offers a free week, a signed BAA with every account and notes you copy into your system. Do not pay until a trial has checked note quality on your own visits, the audio and transcript settings, patient consent and where data is stored.

Two cautions before the trial. The pricing page shows a discounted first month ($19.49) for the Personal plan but not what follows; Twofold's help centre gives the standard price as $69 a month on monthly billing or $49 a month on annual billing ($588 a year), so budget on those. And the security section and FAQ describe audio retention in two slightly different ways, which is the kind of detail a clinic should settle in writing before the first recorded visit.

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What Twofold lists, as read in November 2026

The figures below are from Twofold's pricing page. Prices are in USD. Pages change, so treat this as a snapshot and check the page when you sign up.

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Notice what the table does not say. The Free plan is described as a seven-day period, not a permanent free tier, so treat it as a trial. The pricing page itself does not say what the second month costs; the help centre does, at $69 a month on monthly billing or $588 a year on annual billing. So for one clinician the real decision is $588 to $828 a year, not $19. Annual billing also carries an exit cost: cancel early and Twofold charges each month used at $69 plus a two-month cancellation fee ($138) before refunding the rest, so a clinician who leaves after three months gets back $243 of $588. Ask for the terms in writing before you enter a card.

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What the page claims on security and data

• Agreements: a signed business associate agreement (BAA) comes with every account at no extra cost, and the page makes a health-privacy compliance claim for its home market and describes "HITRUST aligned" controls. Aligned is not the same as certified, so ask which.
• Hosting: the page names one hosting region, not a choice. If your patients or regulator expect data to stay in another region, this answers the data-location question for you: it does not.
• Encryption: TLS 1.3 in transit and AES-256 at rest.
• Audio: the pricing FAQ says audio is auto-deleted after the note is generated "unless you opt in to retention", while the security section says raw audio is not stored at any time. These two statements are compatible only if retention is off by default and the clinician has to turn it on. Check the setting and ask the vendor to confirm in writing.
• Transcripts: the verbatim transcript stays with the note unless you remove it. The help centre describes a per-session Delete transcription option that keeps the note but permanently removes the transcript, after which Ask Twofold, Regenerate Note and Change Template stop working for that note.
• Training: audio, transcripts and notes are not used to train AI models. The page also says Twofold learns your style from the edits you make, so ask where that personalisation is held and whether it is deleted with your account.
• Other regions: the page claims compliance with privacy rules in some other regions and discloses that data for one of them goes to recipients in the vendor's home region. If you have patients covered by those rules, ask for the exact wording.

For the wider vendor questions that apply to every scribe, audio, retention and BAA questions for scribe vendors is the reference.

Is it suitable for a small clinic? Four honest tests

1. Does it fit your record system? The page says output is copy-paste ready, so there is no direct write-back described. For a clinic with a record system that accepts pasted notes, that is fine. For one that needs structured fields filled automatically, it is not enough.
2. Do your clinicians work in languages other than English? Twofold's help centre lists more than 50 note languages, chosen under Note Settings, then Spoken Language, with an auto-detect option. A listed language is not proof of accurate clinical terms in it, so test with a real session in each language your clinicians use.
3. Does it cover your note types? The page lists clinical templates. Check your own: a first consultation, a follow-up, a procedure note, a letter to a referrer.
4. Can you live with copy-paste? 20 consultations a day is 20 copy-pastes. It takes seconds, but it is also where a note goes into the wrong record. Build a habit of checking the name before pasting.

If your clinic has two to five clinicians, the Group plan is a quote you request. A clinic of that size should ask for a demo before paying and should expect the price to be on request. For comparison across vendors, see what small clinics pay for AI scribes.

The trial checklist: what to test in the free week

Run this with one clinician for seven days. It is a checklist you can copy; tick each item, and write the evidence beside it.

Before the first visit

• Account created with a work email and the BAA signed and saved to your records.
• Retention setting found and recorded (screenshot with no patient data).
• Training and data-use setting found and recorded.
• Consent wording written and added to your patient information.
• Decision made on which visit types are in the trial, and which are excluded (for example, anything involving a safeguarding concern or a child).
• Device and microphone tested in the real room, with the door closed and the usual background noise.

During the visits

• Consent said aloud at the start and recorded in the note, with the option to decline.
• Ten real visits recorded across at least three visit types.
• For each note: time to review and edit, in minutes, and a tick for "used as is", "edited lightly" or "rewritten".
• Any wrong fact noted: wrong drug, dose, side, duration or negation ("no chest pain" turned into "chest pain").
• One test in the telehealth mode, if you use video calls, with audio from both sides.

After the visits

• Check that audio is not retained, by looking at what the account still shows for visit one.
• Delete one test transcript with Delete transcription and confirm the note survives; then delete a test note and confirm what is removed.
• Export a note and a list of notes, and note the format.
• Get the price after the first month and the annual refund terms confirmed in writing, and record the reply.
• Compare minutes per note before and after.

Worked example: scoring ten trial notes

An illustration with made-up figures for a small clinic with a part-time doctor seeing 12 patients a day. Before the trial, she writes notes in 9 minutes each. In the trial she records ten visits across follow-ups, new problems and a medication review.

Average review time is 4.9 minutes against 9 by hand, so about 4 minutes saved per note, or roughly 48 minutes across 12 patients a day. But look at what the table shows beyond the average: three notes (3, 7, 9) contained a factual slip that she caught only because she reviewed carefully. Two were in medication or side details. That is why the pass mark is not just time saved. A sensible pass rule: at least seven of ten usable with light edits, and no uncorrected factual error reaching the record.

Three clinic types and how the trial should differ

A solo doctor in a short-appointment clinic

Ten-minute visits leave little time to review a note, so review time is the figure that decides everything. Test whether the draft is ready by the time the patient leaves the room. If you routinely spend three minutes fixing it, the tool is about even with typing. Test it on follow-ups, where speed matters, and judge it there.

A therapy or counselling practice

Sessions are long and the content is sensitive. The consent and retention checks outweigh the cost. Decide whether you will record at all for some clients, and note that the page's coding features (CPT and ICD) are on the Personal plan, which may matter for billing but is not the reason to buy. If a client asks for the word-for-word record of a session to be removed, the transcript deletion option above is the step to know before you start.

A multi-clinician clinic with a mix of visit types

Here the question is consistency. Two doctors who use different templates will produce notes a colleague cannot read quickly. Twofold's Group plan lists shared templates, and the trial should test one shared template across two clinicians before you pay for more seats.

Test cases that catch the errors that matter

Scribes do well on clean speech and fail in predictable places. Build five test cases into your trial and record whether each was handled correctly. These are illustrations, adapt them to your specialty.

1. Negation. Say, in a real visit or a role-played one: "No chest pain, no shortness of breath, but some ankle swelling." The draft must not drop the "no".
2. Similar-sounding drugs and doses. Mention a drug and a dose in an ordinary sentence. Check name, dose, frequency and route.
3. Left and right. State a side. Check that it is the same in the note, and that the plan uses the same side.
4. Two speakers. Have a relative interject with a different history. The note should attribute statements correctly.
5. Accents and background noise. Run one visit with a fan or a corridor noise. The result tells you whether to move the microphone.

Keep a simple log: case, what was said, what the note said, whether it mattered. A single dangerous slip in ten notes is a result worth more than any average. The scribe is an assistant for the first draft, and the clinician's review is what makes the record safe.

A comparison to keep alongside Twofold

A trial of one product is a weak basis for a decision. Choose one alternative to run in the same week with the same visits, and compare the same ten-note table. For a small clinic the sensible alternatives are one tool built into your practice software and one other standalone scribe. Is an AI scribe worth it for a small private clinic? goes through how to frame that choice, and free and paid scribe costs for GPs shows what free tiers tend to leave out. If you only trial one product, you will not know whether the quality you saw was good or merely acceptable.

Consent: what to write and what to say

Whatever the tool, patients should know. Consent rules differ by place and profession, so check your own regulator's guidance and your professional body, and have your wording reviewed. Twofold's help centre offers patient consent form templates in PDF and DOCX and an in-app section headed "How to tell my patients about Twofold?", which are a useful starting draft rather than finished wording. The practical structure is the same whichever tool you use.

• Before the visit: a line in your booking confirmation or patient information, saying that the clinic may use an AI note-taking tool and that patients can say no.
• At the visit: say it again, briefly, and wait for an answer. A patient who agreed by email may not remember.
• In the note: record that consent was given or declined.
• For sensitive visits: offer to switch off for part of the visit, and decide in advance which visit types you will not record.

An illustrative script, to adjust to what your tool's settings actually do: "I use a tool that listens and drafts my notes so I can look at you instead of the screen. I read and correct every note. The recording is not kept once the note is drafted. Are you happy for me to use it today? You can say no and I will type as usual." Rolling out an AI scribe without losing patient trust has more wording and what to do when a patient says no.

Data location and what to ask the vendor

The page names a single hosting region. Whether that matters depends on your patients and your regulator. If your clinic sees patients covered by rules that restrict transfers of health data, or a public funder requires data to stay in a region, you need a written statement from the vendor on the transfer basis, not a sentence on a web page. Send these questions.

We are a small clinic considering Twofold. Please confirm in writing:

1. Where is audio processed and where are notes and transcripts stored?
2. Is raw audio retained at any point? What is the default retention setting, and can an
   administrator lock it off?
3. Which sub-processors (including any AI model providers) receive audio or text?
4. Is patient data used to train or improve any model, yours or a provider's?
5. Please send the BAA or data processing agreement we would sign.
6. Please confirm the Personal price after the first month, monthly and annual, and quote
   the Group plan for three clinicians.
7. What can we export, in what format, and how long until data is deleted if we cancel?

Keep the replies with the clinic's data records. If the vendor answers all seven plainly within a few days, that is a good sign about how it will treat you later.

Cost: what a small clinic should budget

The pricing page shows only a first-month offer, but the help centre gives the standard Personal figures, so a budget can be built on them. Group pricing stays a quote.

• Annual billing: $49 a month a clinician. For three clinicians that is $147 a month, or $1,764 a year, paid up front, with the early-cancellation charge described above if a clinician leaves.
• Monthly billing: $69 a clinician. For three clinicians that is $207 a month, or $2,484 a year, with the freedom to stop at the end of any month.
• Group quote: unknown. The help centre lists volume discounts and an organisation-wide BAA; ask for three clinicians at the same time and compare with the monthly figure.

Illustration: a clinician saving 4 minutes a note across 12 notes a day is saving 48 minutes a day, about 16 hours in a 20-day month. At $69 a month that is about $4.30 an hour of time recovered, which is low compared with most clinical time. The cost question is therefore small compared with the risk question: errors in notes, and data handling. Budget the review time too, because the saving shrinks if review is thorough, which it should be.

Trial shortcuts that hide a scribe's weak spots

• Trialling on easy visits only. Follow-ups are easy for any scribe. Include a new problem, a medication review and a visit with a second person in the room.
• Judging by the first note. The first is usually the best, because you pay attention. Judge by notes seven to ten, when you start trusting it.
• Skipping consent in the free week. A trial is still a real patient's voice. The same rules apply.
• Assuming "any record system" means automatic. Copy-paste is a manual step. Time it.
• Treating a free week as free of risk. The data goes to the vendor whether or not you pay.
• Forgetting to decide who owns the notes. The clinician reviews and signs. The tool never does.

If the clinic is larger than a few people, shared templates in a group practice matters more than the individual price. And if you would rather plan the trial with someone, that is what my AI implementation consultation covers; you can get in touch here.

How to decide at the end of the week

Write one page with four lines. Quality: how many of ten notes were usable with light edits, and what errors appeared. Time: average minutes per note, before and after. Risk: the answers on consent, retention and data location, and whether anything is unresolved. Cost: the renewal price and the three-clinician figure. If quality is seven of ten or better, errors were caught and none was dangerous, the data answers are in writing and the renewal fits, move to Personal on monthly billing for three months before any annual commitment. If any of those fail, say no for now, and note the reason so you can revisit it when the product changes.

Questions clinicians ask before trialling Twofold

Does Twofold work with my record system?

Its page says it works with any record system, with output that copies and pastes cleanly into several large systems and SimplePractice. Its FAQ describes copy-paste rather than a direct write-back, even though one line elsewhere says 'push to your EHR'. If you need notes to flow into a specific system automatically, ask the vendor for a written statement of exactly how.

Is the free plan enough to judge it?

It is enough to judge note quality on your own sessions, because the page lists all templates and the AI assistant on Free. It is not enough to judge the coding and reporting features, which the page places on Personal. Run the free week for quality, then decide whether those extras matter.

What should I tell patients?

Tell them a tool records and drafts the note, that you review it, what happens to the audio, and that they can decline at any visit. Put it in your consent wording and say it aloud at the start of the first recorded visit. Keep a record of who agreed.

What if the price changes after the first month?

The pricing page shows only the first-month offer. Twofold's help centre gives the standard Personal price as $69 a month billed monthly, or $49 a month billed annually at $588 a year. Confirm the figure in writing before entering card details, and put the first renewal date in your calendar so you can cancel if it does not fit.

Further reads

• What Is an AI Scribe and How Does It Work in a Consultation? — How a scribe works inside a consultation.
• AI Dictation Software for Doctors: Dictation or Ambient Notes? — Dictation or ambient notes for doctors.
• AI Medical Transcription Services vs Human Transcribers for Small Clinics — AI transcription against human transcribers.
• AI Scribe for Dentists: Will It Write Back to Your Software? — Will a scribe write back to your software.
• Best AI Scribe for Physical Therapy: Four Tools Compared — Four scribes compared for physical therapy.
• AI Note-Taking Tools for Therapists: A Confidentiality Checklist — A confidentiality checklist for note tools.
• Best AI for Healthcare Providers: What to Buy First by Pain Point — A buying order for a small practice: price your missed calls, late notes and denied claims, then pick the phone agent, scribe or claim check.
• AI Scribe for Audiology: Fitting Notes, Counselling and Consent — Four AI scribes compared for fitting appointments, with filled-in fitting and counselling notes and consent wording for patients who struggle to hear.
• AI Scribe for Optometrists: Exam Notes, Templates and a Test Plan — AI scribes for eye-exam notes compared by how they reach your EHR, with a filled exam template, consent wording and a two-week test plan.
• AI Tools and AI Development: The Complete 2026 Guide — the AI hub, including every tutorial in the AI-for-business series.

Sources: Twofold pricing and policy pages (trytwofold.com), read November 2026. Where the page contradicts itself, the tutorial says so.