Solo PA medical scribe under $100/mo: the 2026 DIY stack
Solo PAs, NPs, and MDs in 2026 face the same documentation problem the big systems face — without the procurement budget. Suki at $299/month, Nuance DAX at $830, and even Heidi at $110 stack up faster than a small practice can amortize. Here is the working DIY scribe stack that actually performs at $58-$95/month for a solo provider, with a clear upgrade path when you outgrow it.
The 4-step pipeline
- Record encounter — iPhone Voice Memos, Android Recorder, or a $40 lavalier mic clipped to your white coat. 15-30 min/encounter.
- Transcribe with Whisper — upload to LessRec, get verbatim transcript with speaker labels back in ~30 sec/min of audio. $0.05/min.
- Generate the SOAP note — paste transcript into Claude.ai (free) or ChatGPT Plus ($20/mo flat), with a saved SOAP-template prompt. 5 sec per note.
- Review and paste into EHR — you read the note, fix any ambiguity, paste into the encounter record.
The actual monthly bill
| Provider type | Audio min/mo | LessRec ($0.05/min) | LLM cost | Total |
|---|---|---|---|---|
| Part-time NP (50 visits, 10 min each) | 500 | $25 | $0 (Claude.ai free) | $25 |
| Solo PA (100 visits, 15 min each) | 1,500 | $75 | $20 (ChatGPT Plus) | $95 |
| Solo MD high-volume (200 visits, 12 min each) | 2,400 | $120 | $20 | $140 |
| Suki Core (any volume, capped) | any | $299 | included | $299 |
| Heidi Clinician (any volume) | any | $110 | included | $110 |
The SOAP-prompt that works
Save this in Claude or ChatGPT as a saved instruction. Adjust to your specialty.
You are a medical scribe assisting a solo provider. From the transcript below, produce: 1. SUBJECTIVE — chief complaint, HPI in OLDCARTS format, ROS positives/negatives, relevant PMH/PSH/FH/SH/meds/allergies stated. 2. OBJECTIVE — vitals if mentioned, exam findings as documented, any in-office tests results stated. 3. ASSESSMENT — numbered problem list with ICD-10 codes (best match). 4. PLAN — for each problem: orders, prescriptions with sig, follow-up, patient education. Rules: - Do not invent labs or diagnoses not in transcript. - Flag in [ ] any item the provider should verify before signing. - Keep clinical language — no patient-friendly rephrasing. Transcript follows.
What the DIY stack does NOT do
- EHR write-back — you copy/paste. Acceptable for 5-15 patients/day, friction at higher volume.
- Real-time prompts mid-encounter — Suki/Heidi can interject. DIY is post-encounter only.
- Specialty templates — you write your own SOAP prompt. Twenty minutes once, then it sticks.
- Multi-provider compliance reporting — if you have a billing manager who needs audit trails, upgrade.
The HIPAA gotcha
If patients are insured (Medicare, Medicaid, commercial), the audio is PHI. You need a Business Associate Agreement (BAA) with every link in your stack:
- Recording app — iPhone Voice Memos and Android Recorder do NOT include a BAA. Use a HIPAA-compliant recorder (TheraCam Pro, FreedHIPAA, or your EHR's encounter-capture if available).
- Transcription — standard LessRec API tier is for non-PHI audio. Contact us for the HIPAA tier with BAA.
- LLM for note generation — ChatGPT $20/mo does NOT include BAA. Use ChatGPT Enterprise (~$60/user/mo) or Claude API plan with HIPAA addendum.
For cash-only practices (concierge, IV-bar, weight-loss clinics, sports-rec), the standard tiers are fine and you save the HIPAA premium.
When to upgrade to brand-name
Switch to Suki, Heidi, or Abridge when one of these is true:
- You bill 200+ encounters/month and copy-paste friction is more painful than the seat fee.
- Your EHR (Epic, athena, eClinicalWorks) has a certified Suki/Abridge integration that writes back automatically.
- Procurement or compliance requires a vendor relationship with audit logs and SOC 2 Type II.
- Specialty templates are pre-built and save you the prompt-engineering time.
For the new-grad PA running cash-only urgent care
$25-95/mo gets you 80% of the value of a $299/mo brand-name scribe. Start with the DIY stack. Save the difference. Upgrade only when the friction earns the seat fee back.