Can an insurance company read an AI-written therapy note?

Usually, yes. Under HIPAA, psychotherapy notes that a therapist keeps separately from the medical record need the client's authorisation before they are disclosed, with few exceptions. But summaries of diagnosis, treatment plan, symptoms and progress are not psychotherapy notes. Those are exactly what an AI scribe writes, and they are part of the record insurers can see.

What counts as a psychotherapy note?

The Department of Health and Human Services defines them as notes by a mental health professional that document or analyse the contents of a counselling session, kept separate from the rest of the record. The definition excludes medication, session times, the type and frequency of treatment, test results, and summaries of diagnosis, functional status, treatment plan, symptoms, prognosis and progress.

Which kind does an AI scribe produce?

Almost always the second kind. A SOAP, DAP or BIRP note is a structured summary of symptoms, interventions and plan. That is a progress note, and it lives in the record.

Some tools go further. A clinician in a psychology forum described a clinic system that records and transcribes the entire conversation and places the transcript in the patient's chart. A transcript saved into the chart is not being kept separately.

What are therapists worried about?

The founder of a psychology group named it plainly as a reason for the practice's no-AI policy: keeping people at a client's insurer from seeing private session notes. Another clinician asked a sharper question: are these recordings part of the medical record at all? The honest answer is that it depends on where they end up.

What should I do?

Find out whether your tool keeps a transcript or audio after the note is written, and where. Keep any process notes you want protected separate from the record. Ask your own counsel about your setup. This is not legal advice.

The short version

Insurers can generally see progress notes, and progress notes are what AI scribes write. Separately kept psychotherapy notes have extra protection, but a transcript saved into the chart is not separate. Solanto's Private Mode is being built for therapy practices so the note never leaves the device.

Solanto has not shipped yet. The price is on the page rather than behind a call, and early access is open: solanto.ai/pricing

Ask the colleague who uses a scribe where the transcript lives after the session. Most will not know.