Guide · Business Texting
Which business texting platforms are actually HIPAA-compliant — and what the BAA costs
Plenty of SMS vendors market 'HIPAA-compliant texting.' Far fewer will sign the Business Associate Agreement that makes it real. Here's where the marketing claim and the signed paperwork actually line up.
For a clinic, a dental office, or a home-health agency, “Can I text patients?” is really two questions: does the vendor claim HIPAA compliance, and will it sign a BAA — the Business Associate Agreement that legally binds it to protect the data you send through it? Marketing answers the first. Only paperwork answers the second, and the gap between them is wide.
In our business-texting dataset, seven vendors touch HIPAA in some form. Only two publicly pair the compliance claim with a named, available BAA.
The two that actually sign: Avochato and Textline
Avochato is the cleanest answer. It states HIPAA compliance and offers BAAs through its Custom (Premium) tier. You don’t have to buy the enterprise tier to start, either — its pricing is unusually transparent for this category:
- Pay-as-you-go: $0 base, $0.08 per segment, 5 users included
- Standard: $210/mo base, which drops the per-segment rate to $0.03, 5 users included
The crossover is simple arithmetic: below roughly 2,000 segments a month the $0.08 pay-as-you-go rate wins; above it, the $210 base pays for itself by cutting the marginal rate. A small practice sending appointment reminders to a few hundred patients lives comfortably in the pay-as-you-go band — meaning HIPAA-eligible texting on Avochato can start at $0/mo plus usage, with the BAA available when you formalize it.
Textline is the other vendor that publishes both HIPAA support and an available BAA (for an additional fee). The honest caveat: Textline withholds its base price on the live pricing page — the tier structure is public (Essentials at 3 agents + 600 credits/mo, Pro at 5 agents + 2,000 credits/mo) but the monthly figure routes to sales. So we can confirm the compliance posture but not quote you a verified price. If you need a shared-inbox support tool with a BAA and don’t mind a sales call, it belongs on your shortlist; if you need a number before you talk to anyone, it doesn’t.
The “HIPAA-marketed” middle: real claim, missing paperwork
Three more vendors market HIPAA compliance but do not name a BAA on their pricing pages — which means the claim is real but the binding document isn’t confirmed and you’ll need to ask:
| Vendor | HIPAA stance | Entry price | BAA on page? |
|---|---|---|---|
| SimpleTexting | Markets HIPAA healthcare texting | $39 / 500 credits | Not stated |
| SlickText | Markets HIPAA-compliant product | $29 / 500 credits | Not stated |
| Heymarket | States SOC 2 + HIPAA enablement | $49/user/mo | Not named |
These are not disqualified — a vendor can absolutely sign a BAA it doesn’t advertise — but you should treat “HIPAA-compliant” in their marketing as the start of a procurement conversation, not the end of one. The price difference is meaningful too: at the 500-credit entry level, SlickText ($29) and SimpleTexting ($39) are bundled-credit plans, while Heymarket ($49/user/mo) is a per-seat product that meters messages at $0.03/segment on top of the seat fee — a structurally different bill that gets expensive fast across a team.
The edge case: Quo’s “HIPAA ready”
Quo (the platform formerly known as OpenPhone) lists “HIPAA ready” as a cross-plan feature and is the cheapest entry on the board at $19/user/mo, with unlimited US/CA texts and calls bundled per seat. But “HIPAA ready” is a feature label, not a signed agreement — Quo’s BAA terms require contacting sales. For low-sensitivity reminders it’s attractive on price; for protected health information, “ready” is not the same as “covered.”
How to read this
If you need texting that is genuinely defensible under HIPAA, the field is two names with a public BAA — Avochato and Textline — and Avochato is the only one that also publishes a price you can act on today (from $0/mo + $0.08/segment, or $210/mo at higher volume). Everyone else either markets compliance without confirming the paperwork (SimpleTexting, SlickText, Heymarket) or labels a feature “ready” without signing anything (Quo). For a healthcare buyer, the question was never “who is cheapest” — it’s “who will put it in writing,” and that filter alone cuts an 11-vendor priced field down to two.