Nine months after announcing its seed funding round, Prosper AI banked $30 million to scale its agentic AI platform to power administrative tasks from patient scheduling to insurance verification and patient billing.
While there are many voice AI companies that focus on a specific task like patient scheduling or billing, Prosper AI was designed to manage the broader patient journey, according to executives. The platform answers patient calls, schedules appointments directly in the electronic health record, verifies insurance benefits, automates patient billing and contacts insurers on the phone when additional information is needed.
Prosper AI's ambition is to build an AI workforce for healthcare operations teams, Xavier de Gracia, the startup's co-founder and co-CEO, told Fierce Healthcare. Prosper AI first shared the funding news with Fierce Healthcare.
"We believe that three to five years from now, larger patient groups and health systems are going to have a layer of workforce that's going to be AI, not only humans, and it's going to complement the work that humans are doing, and we believe that EHRs are going to partner and are already partnering to build a layer on top of the electronic health record. Our vision is to be completely agentic. Voice is just one of the channels where you coordinate patients, providers and insurance companies, but there's other ways that this coordination happens, there's the APIs that we already do, there's fax, there's browser-based AI to get information from insurance portals, and so what we're building is really this workforce that's going to help across the full journey from pre-visit and post-visit," de Gracia said.
Andreessen Horowitz (a16z) led the series A round with participation from Base10 and continued support from Emergence Capital, Y Combinator and Company Ventures. a16z has placed a lot of bets on AI companies and Prosper AI stood out because of the "scope of their ambition," Jay Rughani, partner at Andreessen Horowitz, said.
"They want to eliminate every administrative friction point between a patient and the care they need. What convinced us was the pattern we kept hearing from customers — providers would deploy Prosper AI for scheduling, then quickly ask them to take on insurance verification, then billing, and so on. That pull-through only happens when your technology can consistently guide patients through the care journey end-to-end. It's no surprise Prosper AI is winning the vast majority of competitive evaluations they enter," Rughani said.
With the new funding, Prosper AI plans to expand its engineering and customer-facing teams, deepen integrations across the largest EHR platforms and accelerate adoption across provider groups and health systems.
Healthcare providers don't want separate tools for scheduling, insurance verification, and billing, de Gracia noted. "They want a single platform capable of managing the workflows that determine whether care happens and whether providers ultimately get paid. That's what we've built, and it's why providers, health systems, and healthcare technology companies are choosing Prosper AI."
Prosper AI launched in 2023 with a more horizontal focus and then narrowed its focus to healthcare operations in 2024. The startup has seen rapid growth since its seed funding announcement in September. Prosper AI says it has grown revenue 5x, added more than 40 healthcare organizations as customers and expanded across more than 150,000 healthcare providers. The company says it now manages $1.3 billion in patient care.
The startup now works with 60 healthcare organizations including large and midsize outpatient groups, including PE-backed outpatient groups such as Preferred Dermatology, health systems such as Jackson Memorial Hospital and healthcare tech companies athenahealth and ImagineSoftware.
Prosper AI's platform is tailor-made to handle patient, provider, and payer communications, according to executives. By automating the patient journey end-to-end, Prosper AI helps providers lower administrative costs by more than 40% while giving patients visibility into their coverage and financial responsibility before care is delivered, according to the company. The result is a single platform that manages both patient and payer workflows from appointment request through reimbursement, executives said.
The aim, Prosper AI executives say, is to use agentic AI to help eliminate waste, drive cost savings and increase revenue while also supporting a better patient experience.
"We've essentially built an AI platform that's able to create several agents that are coordinated with each other. We start with the patient scheduling, so we pick up the phone when someone comes in, we're connected into the HR, we're able to like see the availability of appointments, we're able to screen the patient, understand which is the type of appointment that they need, and then we go beyond that. That's where the secret sauce comes in. We check eligibility real time through APIs, but also, if we realize that we don't have enough deductible information, for example, for a certain type of appointment, we'll do an outbound call to the insurance companies, go over the phone tree, get that data, put it back into the system, and do that cost estimate of that visit, and then finally, with that information, inform the patient about the cost of the visit before the visit and their responsibility and enabling them to do the copay up front," de Gracia said.
"What we built is this ability to not over-fit the platform for scheduling but actually be able to do inbound and outbound calls and is able to be multichannel," he added.
Providers using Prosper AI's platform report they can manage high call volumes and deliver faster, more reliable patient access. Providers also are reporting a reduction in operating costs and a revenue lift.
"For our customers, we're seeing up to 60% and 70% automation of some workflows, like the scheduling workflow. We're also seeing revenue increases of up to 12% because now it's not only about picking up the phone and not having hold time, it's about making sure that those patients are financially cleared for that visit. We're seeing these increases in revenue driven by the availability of the workforce, but also by increasing accuracy on being able to have those patients financially cleared upfront of the visit," de Gracia said.
Prosper AI currently has three core AI agents for scheduling, insurance benefits verification and billing, but the company is building more use cases that are part of the administrative journey of the patient, noted Josep Mingot, Prosper AI co-founder and co-CEO.
"We're expanding more on this, call it the long tail of patient administrative communications and that applies on the insurance side as well, so prescription refills and insurance updates," he said.
Prosper AI executives say the company wins 80% of competitive evaluations as providers and health tech companies increasingly look for end‑to‑end solutions, not a single‑feature tool.
"We evaluated seven different vendors through an extensive RFP and live demonstration process and concluded that Prosper AI had the most comprehensive platform," said Jonathan Banta, CEO of The 44 Group, and co-founder of The Executive Roundtable, a provider consortium representing more than 600 physicians. "The difference wasn't simply scheduling. Prosper AI was the only platform capable of handling insurance verification, patient financial responsibility, and the broader workflows required to support the entire patient journey."
"Out of the gate, Prosper AI was handling more than 50% of our patient conversations end-to-end, including complex cases involving real-time benefits verification," Noah England, COO of Piedmont Dermatology, said in a statement. "Many organizations using other AI solutions remain stuck at 20% to 30% automation because those systems stop at scheduling."
EHR and health tech companies also are rapidly adopting AI solutions. Prosper AI says it has integrations across athenahealth, ModMed, Veradigm, ECW, ImagineSoftware and other leading EHRs.
Athenahealth, a large ambulatory EHR platform, selected Prosper AI after evaluating multiple AI solutions for internal voice AI workflows. Imagine Software, a healthcare software company serving more than 100,000 physicians, also selected Prosper AI after conducting a competitive evaluation.
"We reviewed multiple AI platforms, and Prosper AI consistently delivered the strongest performance, now handling thousands of conversations per day across multiple clients on our platform," said Sam Khashman, CEO of ImagineSoftware, in a statement. "In repeated side-by-side evaluations, Prosper AI achieved the highest accuracy and completion rates."