Prosper AI secures $30 million from a16z to streamline the patient journey through automation.

      A significant portion of the high costs associated with American healthcare occurs before a doctor ever sees a patient and afterwards. Someone is responsible for scheduling the appointment, confirming insurance coverage, calculating the patient's financial responsibilities, and following up with the payer if a claim encounters delays. This process is slow and fragmented, leading to estimates that suggest it wastes hundreds of billions of dollars annually. Prosper AI has now secured $30 million to deploy a team of AI phone agents to tackle these issues.

      The Series A funding round was led by Andreessen Horowitz, with Base10 participating, alongside returning investors including Emergence Capital, Y Combinator, and Company Ventures. Prosper, which was founded in 2023 by MIT and Harvard graduates Xavier de Gracia and Josep Mingot and operates between Madrid and New York, had previously raised $5 million in a seed round last September, indicating the rapid pace at which the company claims to be growing. Since that time, it asserts that its revenue has increased fivefold and that it has onboarded over 40 healthcare organizations as clients.

      Prosper argues that scheduling is merely the initial phase. While the first generation of healthcare voice AI focused solely on making appointments, Prosper states that its platform not only handles patient calls but also schedules directly within electronic health records, verifies insurance benefits, automates billing, and contacts insurers when more information is needed for a claim.

      The company positions itself as managing both the patient and payer aspects of every appointment, from the initial phone call to final reimbursement, claiming to reduce providers’ administrative expenses by over 40 percent.

      The market it is pursuing is extensive and well-researched. Independent analysis estimates the costs related to billing and insurance administration in U.S. healthcare to fall between $400 billion and $496 billion annually, making Prosper's estimate of "over $450 billion" seem reasonable.

      The more challenging aspect is the disjointed nature of the processes: scheduling, verification, and billing have traditionally operated within separate systems managed by different teams, which is the gap Prosper aims to fill.

      The company highlights several notable clients, including the private equity-backed dermatology firm Preferred Dermatology, Jackson Memorial Hospital in Florida, and technology firms like Athenahealth, a major ambulatory EHR platform in the U.S., and ImagineSoftware, which claims to process over $65 billion in claims annually.

      Prosper states that both Athenahealth and ImagineSoftware chose their platform after comparative evaluations with competing products, and claims it currently succeeds in about 80 percent of the competitive assessments it participates in, a statistic attributed to their own reporting.

      For Andreessen Horowitz, the strategy involves a land-and-expand approach. “Providers would start with Prosper AI for scheduling, then soon request assistance with insurance verification, followed by billing, and so on,” explained Jay Rughani, a partner at the firm. “That pull-through occurs only when your technology can reliably guide patients throughout the entire care journey.” This investment aligns with broader trends we have observed, from a16z-backed Telepatia in Latin America to the increasing interest in enterprise AI ‘teammates.’

      Prosper intends to use the new funds to grow its engineering and customer teams and to enhance integrations with major EHR platforms. According to co-CEO de Gracia, the long-term goal is to create “a single platform capable of managing the workflows that decide whether care is provided and whether providers ultimately receive payment.”