Nine months after announcing a seed funding round, Prosper AI has raised $30 million to expand its Agent AI platform to power administrative tasks from patient scheduling to insurance verification to patient billing.
Executives say that while many voice AI companies focus on specific tasks such as patient scheduling or billing, Prosper AI is designed to manage a broader range of patient behaviors. The platform answers patient calls, schedules appointments directly in the electronic medical record, verifies insurance benefits, automates patient billing, and calls insurance companies if 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 will have a workforce of humans as well as AI to complement the work that humans are doing. We believe EHRs will partner, and are already partnering, to build a layer on top of electronic health records. Our vision is to become fully agentic. Voice is one of the channels that aligns patients, providers, and payers. But there are other ways to make this adjustment.”We have APIs that we already have in place, we have faxing, we have browser-based AI to pull information from insurance portals, and what we’re building is actually a workforce that can help throughout the entire journey, from pre-visit to post-visit,” de Gracia said.
Andreessen Horowitz (a16z) led the Series A round with participation from Base10, with continued support from Emergence Capital, Y Combinator, and Company Ventures. a16z has made a lot of bets on AI companies, and Prosper AI stood out because of “the breadth of their ambition,” said Jay Rugani, a partner at Andreessen Horowitz.
“They want to eliminate every administrative friction point between a patient and the care they need. What convinced us was a pattern we continued to hear from our customers: Providers deploy Prosper AI for scheduling, then quickly ask for insurance verification, billing, etc. That pull-through only occurs when technology can consistently guide patients end-to-end through their care journey. Prosper AI It’s no surprise that they win the majority of the competitive ratings they enter,” Rughani said.
With new funding, Prosper AI plans to expand its engineering and customer-facing teams, deepen integration across the largest EHR platforms, and accelerate adoption across provider groups and health systems.
Providers don’t want separate tools for scheduling, insurance verification and billing, de Gracia noted. “They want a single platform where they can manage the workflows that determine whether care is delivered and ultimately whether providers are compensated. That’s what we built, and that’s why healthcare providers, health systems, and medical technology companies choose Prosper AI.”
Prosper AI launched in 2023 with a more horizontal focus and narrowed its focus to the healthcare business in 2024. The startup has experienced rapid growth since announcing seed funding in September. Prosper AI says it has grown revenue five times, added more than 40 healthcare organizations as customers, and expanded to more than 150,000 healthcare providers. The company says it currently manages $1.3 billion in patient care.
The startup currently works with 60 healthcare organizations, including large and medium-sized outpatient groups such as PE-backed outpatient groups such as Preferred Dermatology, health systems such as Jackson Memorial Hospital, and healthcare technology companies athenahealth and ImagineSoftware.
Prosper AI’s platform is customized to handle patient, provider and payer communications, executives said. By automating the patient journey end-to-end, Prosper AI helps healthcare providers reduce administrative costs by more than 40%, while giving patients visibility into their insurance coverage and financial responsibilities before providing care, according to the company. The result is a single platform that manages workflows for both patients and payers, from appointment requests to reimbursements, executives said.
According to Prosper AI executives, the goal is to use agent AI to eliminate waste, drive cost savings, and increase revenue while supporting a better patient experience.
“We’ve basically built an AI platform that allows us to create multiple agents that work with each other. We start with patient scheduling, which means when someone comes in, we answer the phone. It connects to HR, checks appointment availability, screens patients, understands the type of appointment they need, and then goes beyond that. Here’s where the secret sauce comes in. “Not only with the API, but for example, if we find out that we don’t have enough deductible information for a certain type of appointment, we can call out to the insurance company, go down the phone tree, get the data, put it back into the system, do a cost estimate for that visit, and then finally use that information to notify patients before the visit about the cost of the visit and their responsibilities so that they can prepay their copays,” De Gracia said.
“What we’ve built is this ability to not overfit into the platform for scheduling and actually be able to make incoming and outgoing calls and be multi-channel capable,” he added.
Providers using Prosper AI’s platform report being able to manage high call volumes and provide faster, more reliable patient access. Providers are also reporting lower operating costs and increased revenue.
“For our customers, some workflows like scheduling workflows are being automated by up to 60%, 70%. We’re also seeing revenue increases of up to 12%. It’s not just about answering the phone and eliminating hold time, it’s about helping patients secure their visit economically. These revenue increases are driven not only by workforce availability, but also by improved accuracy in determining whether patients can be admitted financially,” de Gracia said.
Prosper AI currently has three core AI agents that perform scheduling, insurance benefits verification, and billing, but the company is building out more use cases that will become part of patient management operations, said Josep Mingot, co-founder and co-CEO of Prosper AI.
“We’re expanding this even further, and we call it the long tail of patient management communications, and that applies to the insurance side as well: prescription refills and insurance renewals,” he said.
Prosper AI executives say the company has earned 80% of competitive ratings as providers and health tech companies increasingly seek end-to-end solutions rather than single-function tools.
“The 44 Group’s CEO and co-founder of The Executive Roundtable, a provider consortium representing more than 600 physicians, said Jonathan Banta. “The difference wasn’t just scheduling; Prosper AI was the only platform that could handle the extensive workflows needed to support insurance verification, patient financial responsibility, and the entire patient journey.”
“Prosper AI was handling more than 50% of patient conversations end-to-end from the beginning, including complex cases with real-time benefit verification,” Noah England, COO of Piedmont Dermatology, said in a statement. “Many organizations using other AI solutions only have 20% to 30% automation because these systems stop on a scheduled basis.”
EHR and health tech companies are also rapidly implementing AI solutions. Prosper AI says it integrates with athenahealth, ModMed, Veradigm, ECW, ImagineSoftware, and other leading EHRs.
Athenahealth, a large ambulatory EHR platform, selected Prosper AI after evaluating multiple AI solutions for its internal voice AI workflow. Imagine Software, a healthcare software company serving more than 100,000 physicians, also selected Prosper AI after conducting a competitive evaluation.
“We considered multiple AI platforms, and Prosper AI consistently delivered the strongest performance, and we now process thousands of conversations a day across multiple clients on our platform,” Sam Khashman, CEO of ImagineSoftware, said in a statement. “Through iterative evaluation, Prosper AI achieved the highest accuracy and completion rates.”
