BastionGPT vs Twofold Health: AI Medical Scribe Comparison for 2026

A full AI assistant, not only a scribe

Twofold is deliberately focused: audio or a summary goes in, a structured note comes out, with treatment plans and progress tracking attached to the documentation workflow. It does not include a general clinical AI assistant, and there is no chat interface for work that falls outside the note.

BastionGPT includes an unlimited AI assistant on every plan, alongside the scribe. Clinicians use it to draft referral letters, insurance appeal letters, treatment plans, and patient education materials; review documentation for incorrect names, pronouns, vague language, and suspected under- or over-coding; and analyze lab summaries and spreadsheets. BastionGPT achieved 99.3% sentence-level accuracy on clinical documentation tasks in a peer-reviewed study by Baylor College of Medicine and Texas Children's Hospital researchers, and reports that AI scribe users reclaim an average of 90 minutes per day.

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Less than half the price at the entry tier

Twofold's Personal plan costs $69 per month billed monthly. The $49 rate requires annual billing as a single $588 upfront payment. A solo clinician pays $588 to $828 per year for a scribe.

BastionGPT Professional costs $20 per user per month, $240 per year, with no upfront commitment, and annual billing adds a free month. That is a saving of roughly $350 to $590 per clinician per year, and the $20 plan includes the full AI assistant, not only the scribe. Even BastionGPT Professional Plus at $45, which adds 1,000+ page document analysis, image and spreadsheet reading, and manual model selection, costs less per year ($540) than Twofold's annual rate ($588). Twofold publishes no group pricing; a practice must request a custom quote, while BastionGPT's team pricing is the same published $20 to $75 per user at any size.

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Reads the records your practice receives

Clinical work involves documents that never came from a recorded visit: prior treatment records, psychological and neuropsychological evaluations, hospital discharge paperwork, insurance denials, and faxed outside records. Twofold does not take documents; its inputs are session audio, dictated summaries, or typed key points.

On Professional Plus and Ultra plans, BastionGPT reads 10+ documents at once with 1,000+ pages of combined context, covering PDF, Word, Excel, CSV, PowerPoint, HTML, plain text, and JPG or PNG images, including scanned records, charts, and graphs. A clinician can upload three years of records, an evaluation, and a denial letter, then query, summarize, and cross-reference all of it in one conversation. The Professional plan covers a single PDF, Word, or text document up to 30 pages.

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Published capacity: 240 minutes and 10 labeled speakers

BastionGPT publishes its scribe specifications: recordings up to 240 minutes per session, live or uploaded, with up to 10 speakers separated by voice and automatically labeled with each speaker's name and role, for example clinician, patient, or parent. Extended intakes, family sessions, care conferences, and multi-hour group therapy fit inside one recording, and the transcript shows who said what.

Twofold publishes no maximum recording length and no maximum speaker count anywhere on its website, help center, or app store listings, so buyers cannot verify capacity for long or crowded sessions before committing. Its own group-therapy guide is candid about the multi-speaker problem: speaker diarization "works reasonably with 2 to 3 voices and degrades as participant count grows," and it recommends documenting the clinician's facilitation narrative and key themes rather than attributing dialogue per member. That is honest guidance, and it describes exactly the gap BastionGPT's 10-speaker acoustic fingerprinting was built to close. Twofold's FAQ also notes that full transcripts are viewable in the desktop version only.

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AI models you can see and choose

BastionGPT names its engines: licensed and HIPAA-compliant versions of GPT-5.5, Claude, and Gemini 3 Pro. Every plan selects the best model for each task automatically, and Professional Plus adds manual model selection plus early access to new models as they ship. Model quality drives note quality, and naming the models lets you verify exactly what is reading your patient records.

Twofold describes in-house, clinician-trained models and does not name the underlying AI providers or versions, so note quality rests on a stack you cannot inspect or compare.

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Compliance coverage beyond HIPAA

Both vendors handle HIPAA well. The differences start with everything else. BastionGPT names support for 42 CFR Part 2 substance use disorder records, FERPA-covered school-based records, and Canadian (PIPEDA, PHIPA) and Australian (APP) privacy requirements on every plan, with PHI residency in the United States, Canada, or Australia based on billing geography.

Twofold's security page covers HIPAA and HITECH and states that PHI is stored and processed exclusively on United States infrastructure. Support for 42 CFR Part 2 or FERPA is not published anywhere on its site: Twofold maintains a dedicated solutions page for SUD and addiction treatment documentation, and even that page does not mention Part 2. There is also no non-US hosting option. For a SUD treatment program, a school-based clinician, or a Canadian or Australian practice, those are the lines to compare during procurement.

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A security posture you can inspect, and retention you control

Twofold's security page is clear and well organized: audio is processed to generate the transcript and note, then immediately deleted without ever being written to disk; staff cannot access transcripts, notes, or patient names; data is encrypted in transit and at rest; and PHI is excluded from AI training. Its SOC 2 Type II audit is in progress, with the report to be shared on completion.

BastionGPT runs exclusively on HITRUST CSF certified and SOC 2 Type II attested infrastructure, encrypts data with AES-256 at rest and TLS in transit, and is independently penetration tested at least annually. Security teams can review the evidence today: a trust center available under NDA holds security documentation in addition to extensive public documentation such as the HIPAA BAA and the sub-processor list. Retention stays under your control rather than fixed by the vendor: chats persist until you delete them, documents are removed on deletion or after 30 days of account inactivity, and transcript retention is user-configurable from 1 to 365 days, which matters when a board, payer, or malpractice carrier expects source material kept on a schedule you set. In three years serving more than 10,000 healthcare organizations, BastionGPT has had zero breaches of protected health information.

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Telehealth capture without babysitting the app

Twofold's telehealth workflow is manual: keep the Twofold window open on the computer running the visit, or set a phone running the app next to it. Its FAQ states that the app must remain open and active during capture, and that if the app becomes inactive or the screen goes dark, the visit will not be captured correctly.

BastionGPT captures telehealth sessions alongside Zoom, Microsoft Teams, and Google Meet without a visible recording bot and without a foreground-app requirement, live or from uploaded audio, on sessions up to 240 minutes.

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An API for more than speech-to-text

Twofold offers a developer API that returns transcripts, notes, and structured data from audio, plus a partner program spanning referral, reseller, co-brand, and white-label models. That is a real offering for platforms that want to embed scribing.

The BastionGPT API covers the full platform, not only transcription: HIPAA-compliant chat, document analysis, and audio in one OpenAI-format API, priced from $45 per month with deployment regions in the US, Canada, and Australia and a BAA that extends to API traffic.

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Human support and training on every plan

BastionGPT provides support by email, chat, phone, and video with real humans on every plan, plus a free 30-minute one-on-one training session and team lunch-and-learns, backed by a 99.90% uptime guarantee. Twofold provides a help center with in-app chat and email support on the Personal plan and reserves a dedicated success manager for group plans, and it publishes a status page but no uptime SLA.

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