HIPAA and AI: a buyer checklist

Search for "HIPAA compliant AI" and you will find a long list of tools wearing the label. This guide is for the practice owner, office manager or privacy lead who has to decide whether one of them can touch patient information. It is a checklist, not a ranking. Use it on any AI tool your staff want to adopt: a chatbot, a note taker, an answering service, or the automation that moves data between them.

What people mean by 'HIPAA compliant AI' and why no tool is compliant on its own

HIPAA applies to covered entities (practices, health plans and clearinghouses) and to their business associates. It does not certify software. As Microsoft's HIPAA page puts it, there is currently no certification standard approved by the Department of Health and Human Services (HHS) that demonstrates HIPAA compliance by a business associate.

So when a vendor calls its product "HIPAA compliant", it usually means some mix of three things: it will sign a business associate agreement (BAA), it encrypts data, and it does not train models on your inputs. Those matter. They are not enough, because most of the risk sits in how your practice uses the tool: what goes in, who sees what comes out, how long it is kept, and whether anyone can say what happened six months later. Compliance depends on the covered entity's use of the tool plus a BAA with the vendor. Neither one works without the other.

That also answers the common questions. Is there a HIPAA compliant AI chatbot? There are chatbots whose vendors sign BAAs on certain plans, and a practice can use one in a compliant way. What does it cost? Ask which plan the BAA comes with and price that plan, not the cheapest one on the pricing page.

The BAA question: which plans and vendors sign one

A vendor that creates, receives, stores or transmits protected health information (PHI) for your practice is a business associate, and you need a signed BAA before PHI reaches it. HHS's cloud computing guidance is blunt about it: a cloud provider that stores PHI is a business associate even if the data is encrypted and the provider has no key.

BAAs are usually tied to specific plans and specific services, not to a brand. Microsoft is a useful example for the "Microsoft HIPAA compliant AI" question. As of October 2026, its HIPAA page says its BAA covers a listed set of in-scope enterprise services, which includes Microsoft Copilot and Copilot Chat for commercial customers. The same page says that using Microsoft services does not on its own achieve HIPAA compliance. Your practice still owns how the tool is used. For which ChatGPT plans come with a BAA, see Is ChatGPT HIPAA compliant?

For any vendor, ask three things in writing: Do you sign a BAA? On which plans? Which features and services does it cover? Terms change, so check them again before you renew.

Checklist: retention, training on inputs, access controls, audit logs, who reviews outputs

Put these questions to every vendor, and keep the answers with the contract.

• A signed BAA. If the vendor will not sign one, PHI stays out of the tool, whatever else it offers.
• Data retention. How long are prompts, transcripts, recordings and outputs kept? Can you set the period, and can you have data deleted on request? HHS's sample BAA provisions require the vendor to return or destroy PHI when the contract ends, if feasible.
• Training on your data. Get it in writing that your inputs are not used to train models. Watch for phrases like "to improve our services".
• Where the data sits. Which country and which cloud? Does data leave that region for processing or backup?
• Subprocessors. Who else touches the data? The same HHS provisions require a business associate to make its subcontractors agree to the same restrictions. Ask for the subprocessor list and how you will hear about changes.
• Access controls. Each person signs in with their own account, ideally through single sign-on with two-factor authentication. No shared front desk login.
• Audit logs. Can you see who used the tool, when, and on which record? Can you export the log?
• Breach notice terms. Under the HHS Breach Notification Rule, a business associate must tell you about a breach without unreasonable delay and no later than 60 days from discovery. HHS notes in its 2022 breach report to Congress that the parties can agree a stricter timeframe in the BAA. Ask what the vendor's is.
• Who reviews outputs. A person should check anything that reaches a patient or a chart: a summary, a letter, a coding suggestion.
• A staff use policy. Name the approved tools, what may and may not be pasted into them, and who to ask. Our AI policy starting points give you a first draft.

Asking "how do I make AI HIPAA compliant" is really asking how to make this list true for each tool you use.

AI scribes, note takers and answering services: what to ask

These tools collect PHI by design, so the checklist applies in full. Three extra questions matter.

• Recordings and transcripts. Does the tool keep the audio, the transcript, or only the final note? For how long, and who at the vendor can listen?
• Where the note goes. Does it write straight into the chart, or does a clinician approve it first? Draft notes should be reviewed before they are signed.
• Handoff to people. For answering services, how does a caller reach staff, and what happens to urgent calls? Our guide to comparing dental AI receptionists covers booking, handoff and call recording in detail.

The same thinking applies to back office work. Insurance verification with AI moves patient and payer details on every check, so it needs the same BAA and logging questions.

Automation tools in the workflow (Zapier, Make) and BAAs

Automation platforms are easy to forget. A workflow that copies a new patient form into a spreadsheet, or sends appointment details to a chatbot, moves PHI through the automation tool too. That tool needs its own BAA, separate from the AI vendor's.

Zapier. As of October 2026, Zapier's data privacy page says the use of regulated healthcare data, including PHI under HIPAA, is not supported on Zapier, and that Zapier cannot sign BAAs for handling PHI. The page names no plan that changes this. Zapier is still useful for work that never touches patient data, such as marketing, hiring or vendor invoices, but the line has to be drawn in your policy.

Make. As of October 2026, Make's security page does not mention HIPAA or BAAs, and we could not find a current statement of Make's position on its own pages. Ask Make directly, in writing:

• Will you sign a BAA, and on which plan?
• Which parts of the platform does it cover, including execution logs and stored data?
• How long are scenario logs kept? (Make's security page says log data is stored for 30 days by default.)
• Which subprocessors handle the data, and where is it hosted?

Until you have a signed BAA, keep PHI out of Make scenarios. The same applies to any other automation tool: no BAA, no PHI.

Where a controlled layer helps: scoped access, approvals and logging

Most practices end up with several tools, each with its own BAA, settings and logs. A controlled layer sits between those tools and your systems so the rules live in one place. In practice that means:

• Scoped access. Each AI task sees only the records it needs, not the whole schedule or chart.
• Approvals. A person approves anything that changes a record or reaches a patient.
• Logging. Every access and every change is logged, so you can answer "who saw this?" later.

That is how we set up AI work for practices. It does not make any tool compliant, and it does not replace BAAs with each vendor or your own policies. It makes the checklist easier to keep true. Our security page sets out our access controls and data retention, and AI for healthcare teams shows how the work starts. For the other guides in this series, see the healthcare and dental AI guides.

This guide is educational. It is not legal advice and does not replace your privacy officer or counsel.