Twofold AI Scribe Review (2026): Pricing, HIPAA and EHR Fit

What You Need to Know About Twofold's AI Scribe

• Twofold's AI scribe drafts your note from the session, so you can focus on the client instead of typing.
• It costs $49 to $69 a month with no cap on notes. You paste each note into your EHR yourself.
• Use the 7-day trial on a full day of sessions to see how much charting time it gives back.

What Is Twofold?

Twofold is an AI medical scribe that drafts your note from the session. It listens while you stay focused on the client in front of you. When the session ends, you review the draft, fix anything it missed and paste it into your EHR. Twofold says more than 20,000 clinicians use it.³

It's built for clinicians who choose their own tools. You can sign up online, see the price up front and get a business associate agreement (BAA) without a sales call.² The templates lean toward therapy and behavioral health, with DAP, BIRP and group therapy notes alongside SOAP.¹²

Three gaps are worth knowing before you start. Twofold doesn't write notes into your EHR, and group practices get no single sign-on (SSO). Its SOC 2 Type II audit, which some compliance teams ask for, is also still in progress.⁴

Who Should Choose Twofold?

Twofold fits a solo clinician or small practice that wants to stop charting after hours. You need to be comfortable pasting notes into the EHR. It suits therapists in particular, who get DAP, BIRP and group therapy notes at a set monthly price. Practices that need write-back, SSO or a finished SOC 2 report should compare other options first.

How AI is changing therapy documentation is covered in the overview of AI therapy notes.

How Much Does Twofold Cost?

Twofold's Personal plan costs $69 a month, or $49 a month if you pay annually.¹ Both include unlimited notes with "no monthly cap, no daily cap, and no metering," so you never have to ration it on your heaviest days.⁵ Each note also comes with suggested CPT and ICD codes, which gives you a head start on billing.¹

You can try Twofold for 7 days without a credit card.¹ There are "no contracts and no commitments," so canceling is easy if it doesn't fit.⁵ If you subscribe through the iPhone app instead, the price is higher, at $79.99 a month or $699.99 a year.

Per-provider costs across the category are compared in the guide to AI scribe pricing.

How Do Twofold Notes Get Into Your EHR?

Every Twofold note reaches your EHR by copy and paste. Twofold says its notes "copy-paste cleanly into Epic, Cerner, Athena, SimplePractice, and others."³ The upside is that you can keep whatever EHR you already use. The trade-off is that someone moves each note by hand.

There is no direct write-back and no browser extension that fills EHR fields for you.⁶ Twofold's API exists, but it serves software companies building Twofold into their own products rather than practices.⁷

Pasting a finished draft is faster than writing the note yourself, though it still adds a few clicks after every session. During the trial, time the whole path on a real day: copy the note, open the right client and encounter, paste each section into the right field and sign. That number tells you how many minutes you actually get back. How write-back differs from copy and paste is explained in the guide to EHR integrations.

Is Twofold HIPAA Compliant?

Twofold says it is HIPAA and HITECH compliant.¹ Because HIPAA generally requires a BAA with any vendor that handles your clients' protected health information, that agreement matters.⁸ Twofold makes it simple. The BAA is "executed automatically when you sign up," so you are covered before your first recorded session.²

Your clients' data stays out of AI training: Twofold's security page says audio, transcripts and notes are not used to train models.⁴ It also says "Session recordings are never stored on our servers."⁴ Data sits on Microsoft Azure and Google Cloud in US data centers.⁴ If a client asks what happens to the recording, you have a clear answer.

Practices with a formal security review should know that two items are still in progress. Twofold lists its SOC 2 Type II audit as "currently undergoing."⁴ Its homepage describes its controls as "HITRUST CSF aligned," which is different from a finished certification.³ If your compliance team needs the SOC 2 report, ask Twofold for the expected date. What a BAA should cover is laid out in the guide to HIPAA-compliant AI note-taking.

What Note Formats Does Twofold Support?

Twofold drafts the formats therapists and behavioral health clinicians use most: SOAP, DAP (data, assessment, plan) and BIRP (behavior, intervention, response, plan).¹² You can edit intake and treatment plan templates to match how you practice, then share them with colleagues by link.¹¹

Group therapy notes get their own tool. Twofold's group note generator turns one session into a structured note for each participant.¹³ It covers dialectical behavior therapy (DBT), cognitive behavioral therapy (CBT), psychoeducation and support groups.¹³ After an eight-person group, you review eight drafts instead of writing eight notes.

You don't have to record at all. Twofold also works from a dictated summary, typed text or an uploaded audio file.² That helps with clients who would rather not be recorded. The iPhone app syncs with your account, although full transcripts show only on desktop.² If you see clients in more than one language, the help center lists more than 50 with automatic detection.⁹

Does Twofold Work for Group Practices?

Twofold sells a Group plan with seats, an admin dashboard and one bill for the practice.¹⁰ Pricing is by quote. Twofold's group page lists a typical cost of "$49 flat, unlimited" per clinician per month.¹⁰ Each group gets onboarding and a dedicated account manager.¹⁰

Admins can invite and remove members, assign seats and manage billing.¹¹ Shared templates go out through Twofold's support team, so every clinician starts from the same note structure.¹¹ Each clinician keeps a separate client list.¹¹

The plan doesn't have some options group practices tend to want. No SSO option is listed, so each clinician keeps a separate login.¹⁰ Every clinician also pastes their own notes, which means the paste step multiplies across the practice.

What Does Research Say About AI Scribes Like Twofold?

No published study has tested Twofold itself. Twofold says clinicians "Save 2–3 hours per clinician, every week."¹⁰ Independent studies of other AI scribes show what you can reasonably expect from tools in this category.

Three studies give a sense of what to expect.

How often you use the scribe matters. In the randomized trial, physicians used either scribe in only about a third of their visits.¹⁴ The JAMA study found the biggest gains among clinicians who used a scribe in at least half their visits, a level only 32% of users reached.¹⁷ With an unlimited plan, the time you get back grows when you use it on most sessions.

The burnout finding may matter most at the end of a long week. That study compared the same clinicians before and after, so it can't rule out other causes.

AI scribes can also make mistakes. A 2025 npj Digital Medicine commentary reports that they can leave out details or document exams that never happened.¹⁹ Read every draft before you sign it, and give risk assessments and anything a client said about safety the closest look. For how the workflow runs end to end, see the explainer on the AI medical scribe.

What Are Twofold's Gaps?

Five gaps in Twofold can affect a clinician's day or a practice's rollout.

• No EHR write-back. Every note is copied and pasted into the EHR, which adds a few clicks after each session.⁶
• No single sign-on. Group practices get no SSO option, so each clinician keeps a separate login.¹⁰
• SOC 2 still in progress. The SOC 2 Type II audit is "currently undergoing," and HITRUST is listed as "aligned" rather than certified.⁴
• Template rollout through support. Group admins manage seats and billing, and Twofold's support team rolls out shared templates.¹¹
• Two statements on audio. The security page says recordings are never stored, while the homepage mentions an opt-in retention setting.⁴

How Does Commure Scribe Fill Twofold's Gaps?

The security gap closes at any practice size with Commure Scribe. The EHR and admin gaps close once a practice reaches group size.

Getting notes into the EHR. At one to five providers, Commure Scribe also uses copy and paste, from an overlay that sits over the EHR. So a solo therapist moves notes much as they would with Twofold. The difference shows up at group size. Medium and large group practices can get one-click sync with the EHR, which removes the paste step Twofold leaves with each clinician. Commure Scribe lists 60+ EHR integrations, including SimplePractice.

Security review. Commure Scribe is SOC 2 certified and HIPAA compliant, with data stored onshore. For a practice whose compliance team needs a finished SOC 2 report, that closes the open item Twofold still lists as in progress.

What happens to audio. The two tools take different approaches. Twofold says recordings are not stored on its servers. Commure Scribe keeps audio encrypted and uses it only to generate the clinical note. Audio stays active for one year by default, then is archived for at least six years. Clinicians can permanently delete transcripts and notes at any time. A clinician who wants audio gone after each session may prefer Twofold's approach, while a practice that needs an archived record for compliance may prefer Commure's.

Work beyond the note. Both tools suggest codes. Commure Scribe generates suggested ICD-10 and CPT codes in a separate tab for the clinician to check. Its AI Copilot also drafts documents that follow a visit, such as prior authorization requests, work excuse letters and patient emails. It detects 90 languages automatically, and live phone support is available during setup and after.

Twofold has advantages of its own. It publishes a group therapy note generator and a typical group price, while Commure Scribe prices group plans by quote. Commure Scribe's admin controls and advanced integrations are also gated to higher tiers. A solo therapist writing group notes may find Twofold the simpler fit. A growing practice that needs notes in the chart and a finished SOC 2 report may be better served by Commure Scribe at group size.

More AI Scribe Reviews and Guides

These guides cover the scribes and questions that come up when weighing Twofold.

• Pricing tiers, note quality and EHR compatibility are compared in the review of Freed AI.
• Note quality and specialty support are covered in the review of Heidi Health.
• Behavioral health fit and HIPAA handling are covered in the review of Mentalyc.
• Scribes that pair with SimplePractice are compared in the guide to the best AI scribes for SimplePractice.

Time the handoff from note to chart

The fairest test for any scribe is your own schedule. Run Commure Scribe on the same kind of day you tested Twofold, and time each note's path into your chart. Trial terms and plans are listed under Commure Scribe pricing.

Twofold details in this review were checked against Twofold's own pages on September 28, 2026. Prices and features change, so confirm current terms with Twofold before you buy.

This article is for informational and educational purposes only, does not constitute legal, medical, or professional advice, and does not guarantee any particular documentation, security or compliance outcome.

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