Twofold alternatives

Twofold puts unlimited notes, coding, phone apps and a signed BAA into one plan, which makes it a strong value option. People still look elsewhere when they want a free plan, a hospital EHR integration, or help with the paperwork that follows a visit. Here is how the main alternatives line up, based only on their own websites.

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Twofold's baseline

Twofold's pricing explainer states $49 a month billed annually or $69 a month month-to-month, with a first-month offer on its pricing page. The 7-day trial gives full access without a card. Its security page says every account gets a signed BAA, audio is deleted after the transcript and note are made, and customer data is not used to train AI models. It serves primary care, mental health, specialists, nursing, allied health, dentistry, aged care, veterinary medicine and trainees.

Any alternative should be judged against that bundle. If a BAA and phone apps are essential to you, fewer options remain.

The alternatives

Heidi Health offers a Free plan with unlimited transcription and paid Clinician and Teams plans. It has apps for iOS, Android, Windows and macOS, offers a BAA per its compliance page, and lists EHR integration on its Teams plan. Best for clinicians who want a free starting point or notes in a language other than English.
Freed charges from $39 a month for a capped Starter plan, up to $119 a month for Premier, or $104 a month on annual billing. Premier adds letters, coding and push into browser-based EHRs. Freed has a native iOS app and writes the note in English. Best for clinicians in a browser-based EHR who want push rather than paste.
Nabla is built for health organisations, with integrations into Epic, athenahealth, Oracle Health, NextGen and others. No public price was shown. Best when your employer is buying for many clinicians.
ClearPass is a browser app with one plan after a 7-day trial. It writes English notes, adds referral letters, sick notes, patient instructions, medical reports and codes, and handles prior authorization letters and denied-claim appeals from the same visit. It has no EMR link, no native app and no BAA today. Best for doctors whose insurance paperwork is a large part of the day.

Quick matrix

Question	Heidi	Freed	Nabla	ClearPass
Free plan or trial	Free plan	7-day trial	Free try-out link	7-day trial
BAA available	Yes, per its site	Organization-wide, for groups	Not stated on pages checked	No
Android app	Yes	Not confirmed on pages checked	Yes	No; browser
Insurance approval letters	Not listed	Not listed	Not listed	Yes
Price shown on site	Free; paid by region	From $39 a month	No	See pricing

What to check when you move

Therapy formats such as DAP and BIRP are named in Twofold; in another tool you may need to build them as a custom structure. In ClearPass that is My own structure, written once and reused. Check how each tool handles a session with more than two speakers, and whether you can keep the note history you need. ClearPass keeps history only in your browser, so move your old notes into your EMR first.

Run a few typical sessions through the new tool during its trial, compare edit time, and confirm your employer's requirements, especially around BAAs, before switching fully.

Price is rarely the deciding factor at this level, because the gap between these plans is small next to the time a good draft saves. What decides it is fit: the note format you need, whether your employer asks for a BAA, whether you must work from a phone app, and what happens to the paperwork after the visit. Write those four answers down before you start any trial, and you will know within a few days which tool to keep.

What ClearPass does not do

It does not replace your judgement. Every note is an AI draft that you review and correct before it is used.
It is not a medical device and does not make clinical decisions. It is a documentation aid.
It does not connect to your EMR. The note is copy-ready text that pastes into any system.

Privacy

Clinical note content is not stored on ClearPass servers: it is processed to write the note, then discarded. Consultation audio is transcribed and discarded, never stored. Your note history stays in your browser, on your device, and you choose how long it is kept. Common identifiers are removed from typed and transcribed text before it reaches the AI; that is a best-effort safeguard, so leave names, ID numbers and file numbers out where you can. Processing goes through the AI providers named in our Privacy Policy, which sets out exactly what each one receives and how long it keeps it. ClearPass does not sign HIPAA business associate agreements today.

Questions

Is there a cheaper option than Twofold?

Heidi lists a Free plan. Freed's Starter plan is advertised from $39 a month but allows up to 40 notes a month. Compare against how many notes you write.

Which alternatives offer a BAA?

Heidi says it makes a BAA available to every covered entity, and Freed lists an organization-wide BAA for groups. ClearPass does not sign BAAs today.

Is ClearPass good for therapy sessions?

It is built mainly for medical visits. You can set up your own headings, but therapy-specific formats are not built in the way they are in Twofold.

What does ClearPass cost?

The 7-day trial is free, needs no card and simply ends after 7 days, with no automatic charge. After that there is one plan: $78 a month or $858 a year, with every visit transcribed.

Try it on your next clinic day

The full product for 7 days, with no card and no automatic charge. Then $78 a month or $858 a year. Pricing details.

Start free — 7 days, no card

Sources

Checked on 2026-09-29. Prices and features change; the vendor's own site is the final word.