Ask HN: Is Twilio necessary and required to build text and voice agents?

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I have been looking into solutions since their HIPAA requirements require an enterprise plan. I have not tried yet but AWS has Chime SDK.

Twilio will sign a baa

Yes, in the enterprise tier. Very expensive.

thanks for the options! at enterprise scale, is twilio still the most reliable? happy to try other options but i want to abstract out the cpaas layer as much as possible and focus on building performing agents.

reliability and scalability is critical to me

TeleSign is a good alternative

Best option still twilio

Plivo is an alternative.

Plivo, Vonage, Telnyx?