HIPAA-Compliant Alternatives to Granola AI (2026)

If you're looking for a HIPAA-compliant alternative to Granola, it's because Granola doesn't have one to offer: it does not sign Business Associate Agreements, and its published security posture isn't built around PHI handling. That's a dealbreaker for any team whose meetings touch protected health information — clinical operations, care coordination, health-tech product and sales calls, or any vendor conversation where patient data might come up.

This roundup covers six AI meeting assistants that do offer a BAA path, with honest notes on which plan tier you actually need, what's still missing, and where each tool has open questions worth resolving with your own compliance team before you sign anything.

A word on what "HIPAA compliant" actually means here: no software is HIPAA-certified — HIPAA doesn't work that way. What you're evaluating is whether a vendor will sign a BAA, and whether their technical controls (encryption, access controls, retention, audit logging) are strong enough to support your own compliance program. A vendor's marketing page saying "HIPAA compliant" is a starting point for due diligence, not the end of it. Confirm current terms directly with each vendor before deployment.

Methodology

We evaluated tools against five criteria, weighted for a healthcare buyer: (1) whether a BAA is actually available and at what plan tier, (2) additional controls relevant to PHI specifically — redaction, configurable retention, audit logging, access permissioning, (3) transparency and consistency of the vendor's own compliance documentation, (4) pricing clarity, and (5) any known controversies — litigation, disclosed incidents, institutional bans — that a compliance-minded buyer would want to know about. Rankings reflect how each tool scored against these criteria, not vendor relationships.

6 HIPAA-Compliant Alternatives to Granola AI

1. Fellow

Fellow is a HIPAA compliant alternative to Granola AI and signs BAAs, on top of SOC 2 Type II certification and GDPR compliance. What differentiates it for healthcare-adjacent use specifically is the combination of features: configurable zero-day retention (recordings and transcripts can be deleted immediately after processing while AI-generated summaries persist as institutional memory), transcript redaction for names, account numbers, and other sensitive fields, information barrier policies between teams, and a Super Admin API for exam-ready audit logs. Fellow also never trains AI models on customer data.

Pricing: Free, Team ($7/user/month), Business ($15/user/month), Enterprise ($25/user/month, 10-user minimum, annual billing).

Pre-publication flag: Fellow's own materials list HIPAA compliance as a company-wide capability rather than specifying which plan tier includes BAA execution. Public documentation points to contacting the support team to initiate a BAA.

Limitations: Third-party audit summaries require an NDA, which is standard practice. It doesn't publish native EHR integrations, so healthcare teams pairing it with clinical systems will be working through general-purpose CRM/API connections.

2. Otter.ai

Otter announced it had achieved HIPAA compliance in July 2025, following an independent assessment, and will sign a BAA — but only on the Enterprise plan. Basic, Pro, and Business tier users cannot get a BAA and should not put PHI through Otter in any compliant way.

Important context we'd be doing you a disservice to leave out: Otter is currently a defendant in a consolidated federal class action (In re Otter.AI Privacy Litigation, N.D. Cal.), alleging its notetaker records meeting participants — including non-Otter users — without all-party consent, in violation of federal wiretap law and California's Invasion of Privacy Act. A motion to dismiss was argued in May 2026 and is still pending as of this writing; no court has ruled on the merits, and Otter denies wrongdoing. This is a live legal question, not a settled one, but it's directly relevant to any compliance officer evaluating consent workflows for a HIPAA-sensitive deployment, since the allegations go to how the tool captures audio from every participant in a meeting — precisely the kind of workflow question that matters when PHI might be discussed. We'll update this if the court rules.

Limitations: HIPAA compliance is Enterprise-only, which typically means a sales-negotiated contract rather than self-serve signup. The pending litigation, regardless of outcome, is worth factoring into your own legal risk assessment.

3. Fireflies.ai

Fireflies offers HIPAA compliance on request, available on Business plan and above, but full HIPAA configuration (BAA plus Private Storage) is gated to Enterprise. Fireflies has signed BAAs with its AI/ASR vendors (including OpenAI) to prevent PHI from being used in vendor-side training, and its Security Checklist gives admins a self-service view of compliance status rather than requiring back-and-forth with support.

Important context: Fireflies is a defendant in a BIPA (Illinois Biometric Information Privacy Act) class action filed in December 2025 (Cruz v. Fireflies.AI Corp.), alleging its "Speaker Recognition" feature creates and retains voiceprints without the written notice and consent BIPA requires. This is an allegation, not a finding, but it's directly relevant for any team weighing biometric data handling as part of a compliance review.

Limitations: Private Storage — a prerequisite for HIPAA configuration — is an Enterprise-only add-on, and per-seat pricing for Enterprise ($39/seat/month per third-party comparisons we found) runs meaningfully higher than Fellow's equivalent tier; we'd recommend confirming current figures directly with Fireflies sales, as third-party pricing pages are not always current.

4. Avoma

Avoma offers a HIPAA BAA on Enterprise plans, alongside SOC 2 Type II certification, a GDPR-compliant DPA, VPC isolation on AWS, and annual third-party penetration testing. Avoma publishes a Trust Center with SOC 2 report access available to enterprise prospects.

Limitations: Avoma is positioned primarily as a revenue-intelligence/sales-call tool first and a general meeting assistant second, so healthcare and legal-specific features (redaction, information barriers) are less developed in its public materials than Fellow's or Fireflies'.

5. Read AI

Read AI now offers a BAA to support HIPAA compliance, per its own Help Center documentation, alongside SOC 2 Type II reporting and Data Privacy Framework participation. It's worth noting for teams already using Read across email and Slack, not just meetings, since its compliance scope would need to extend across all three surfaces if PHI is in play.

Important context: Read AI has documented instances of joining meetings without explicit invitation, and has reportedly been banned from Zoom/Teams integration at several universities (University of Washington, Chapman University, UC Riverside) over uninvited-bot behavior. Independent review scores for Read AI have also trended lower than category peers on trust and consent-related criteria. None of this is disqualifying on its own, but it's exactly the kind of consent-and-access pattern a compliance team should stress-test before rolling Read AI into any workflow touching PHI.

Limitations: Read AI's HIPAA guidance repeatedly stresses that consumer-facing surfaces (mobile apps, browser extensions) fall outside BAA coverage — PHI should only move through the properly configured, BAA-covered workspace path, which requires more deliberate internal governance than a simple plan upgrade.

6. Sembly AI

Sembly AI includes a HIPAA compliance toggle in account settings, which disables integrations (most Zapier-based automations, some native connectors) that rely on non-HIPAA-compliant third-party apps. This is a meaningfully different model from the others on this list: rather than a separate Enterprise-only BAA process, HIPAA mode is a workspace-level switch with documented tradeoffs.

Limitations: Turning HIPAA mode on measurably reduces the integration surface — you lose most Zapier webhook automations and several native app connections, and Sembly's own documentation notes these can't be automatically restored if you toggle HIPAA mode off and back on. That's a real operational cost worth planning around, not a footnote.

Conclusion

There's no single "most HIPAA-compliant" AI meeting assistant — there's only a fit between what your organization needs and what each vendor will actually put in writing. All six tools above will sign a BAA under the right plan, but the details that matter in practice vary a lot: which tier unlocks it, what happens to raw recordings after processing, whether redaction and audit logging are built in or bolted on, and whether the vendor has any open legal or trust issues worth weighing into your risk assessment.

If your priority is the deepest governance layer in one workspace — redaction, configurable zero-day retention, audit-ready exports — Fellow's feature set is built specifically around that use case, though its BAA tier-gating needs a direct confirmation call. If you want HIPAA compliance without an enterprise sales negotiation, Fireflies' self-service checklist is the more accessible path, with the tradeoff of a pending BIPA suit over its voiceprint feature. If you're weighing Otter, the compliance features are real, but so is an unresolved federal class action about consent — read the docket, not just the marketing page, before you deploy it anywhere PHI might come up.

Whatever you choose, a vendor's "HIPAA compliant" claim is the start of due diligence, not the end of it. Get the BAA in writing, confirm which plan tier it actually applies to, and verify retention and redaction settings match your own compliance program before a single PHI-adjacent meeting gets recorded.

Frequently Asked Questions

Is Granola HIPAA compliant?

No. Granola does not sign Business Associate Agreements, which makes it unsuitable for meetings involving protected health information regardless of other security measures it may have in place.

What does "HIPAA compliant" actually mean for an AI meeting assistant?

No software is HIPAA-certified — HIPAA is a federal law, not a certification body. In practice, "HIPAA compliant" means a vendor will sign a Business Associate Agreement (BAA) and has technical safeguards (encryption, access controls, audit logging, configurable retention) that support a covered entity's own compliance program. A BAA is the legal requirement; the technical controls are what make that agreement meaningful in practice.

Which AI meeting assistants will sign a BAA?

Based on current public documentation, Fellow, Otter.ai (Enterprise plan only), Fireflies.ai (Business plan and above, with full HIPAA configuration on Enterprise), Avoma (Enterprise), Read AI, and Sembly AI all offer a BAA path. Availability and plan-tier requirements change, so confirm directly with each vendor before deployment.

Does HIPAA compliance require the highest-priced plan?

Usually, yes. Across most tools in this category, HIPAA compliance and BAA execution are gated to Enterprise or top-tier plans rather than available on entry-level or mid-tier pricing. Fireflies and Otter both restrict it explicitly to their top tier.

What's the difference between "HIPAA compliant" and "HIPAA eligible"?

"HIPAA eligible" typically means a vendor will sign a BAA and offers the necessary safeguards, while "HIPAA compliant" describes the full system in operation — including your organization's own configuration, access controls, and staff training. A vendor can be HIPAA-eligible; your actual compliance depends on how you configure and use the tool.

Can I use a free or entry-level plan for meetings involving PHI?

Generally no. Every tool in this roundup that offers HIPAA compliance restricts it to a paid, typically top-tier plan. Using a lower-tier plan without an executed BAA to discuss PHI would not meet HIPAA requirements, regardless of the tool's underlying security architecture.

Do these tools train AI models on meeting data that includes PHI?

This varies by vendor and matters more once a BAA is signed, since the BAA should explicitly restrict PHI from being used for model training. Fellow states it never trains on customer data. Fireflies has signed BAAs with vendors like OpenAI specifically to prevent PHI from being used in third-party model training. Confirm this contractually with any vendor before assuming a general privacy statement covers PHI specifically.