Prosper AI raises $30M from a16z to automate patient journey from scheduling to billing

Prosper AI raises $30M from a16z to automate the patient journey

The Madrid- and New York-based startup wants its voice agents to handle scheduling, insurance checks, and billing, not just the first phone call. Most of what makes American healthcare expensive happens before a doctor is ever in the room, and after. Someone schedules the appointment, confirms the insurance, works out what the patient owes, and chases the payer when a claim stalls. It is slow, fragmented work, and by most estimates it wastes hundreds of billions of dollars a year. Prosper AI has now raised $30mn to put a fleet of AI phone agents on the job. The Series A was led by Andreessen Horowitz, with Base10 joining and existing backers Emergence Capital, Y Combinator, and Company Ventures returning. Prosper, founded in 2023 by MIT and Harvard alumni Xavier de Gracia and Josep Mingot and based across Madrid and New York, raised a $5mn seed round only last September, which gives a sense of how fast the company says it is moving. Since that round, it claims to have grown revenue fivefold and added more than 40 healthcare organisations as customers. The pitch is that scheduling was only ever the first step. Where the first wave of healthcare voice AI stopped at booking an appointment, Prosper says its platform answers patient calls, schedules directly inside the electronic health record, verifies insurance benefits, automates billing, and phones insurers when a claim needs more information. The company frames this as managing both the patient and the payer side of every appointment, from the first call through to reimbursement, and says it lowers providers' administrative costs by more than 40 per cent. The market it is chasing is large and well documented. Independent research puts the cost of billing- and insurance-related administration in US healthcare somewhere between $400bn and $496bn a year, so the company's "+$450bn" framing of the waste sits comfortably in range. The harder part is the fragmentation: scheduling, verification, and billing have long lived in separate systems run by separate teams, which is precisely the seam Prosper is trying to close. The company lists some recognisable customers. They include the PE-backed dermatology group Preferred Dermatology, Jackson Memorial Hospital in Florida, and, on the technology side, Athenahealth, one of the largest ambulatory EHR platforms in the US, and ImagineSoftware, which says it processes over $65bn in claims a year. Prosper says Athenahealth and ImagineSoftware both selected it after side-by-side evaluations against competing platforms, and that it now wins around 80 per cent of the competitive evaluations it enters, a figure that is the company's own. For a16z, the appeal is the land-and-expand pattern. "Providers would deploy Prosper AI for scheduling, then quickly ask them to take on insurance verification, then billing, and so on," said Jay Rughani, a partner at the firm. "That pull-through only happens when your technology can consistently guide patients through the care journey end-to-end." The bet sits inside a busy arc we have tracked, from a16z-backed Telepatia in Latin America to the broader scramble around enterprise AI 'teammates'. Prosper says the new money will go toward expanding its engineering and customer teams and deepening integrations with the largest EHR platforms. The longer-term aim, in the words of co-chief executive de Gracia, is "a single platform capable of managing the workflows that determine whether care happens and whether providers ultimately get paid."

Investing in Prosper AI | Andreessen Horowitz

Healthcare runs on the office landline. Behind every doctor is a room you never see: staff in headsets, scheduling patient visits while sitting on hold with insurance companies, typing into the electronic health record (EHR) one field at a time. None of it is medicine, and all of it decides whether you get seen and whether your doctor gets paid. Confirming your insurance coverage before a visit can mean a 40-minute phone call. Get one field wrong and the appointment doesn't clear, the claim goes unpaid, and you land in collections months later - for care you assumed was covered. Decades of patient portals later, the work still happens over the phone. That's the layer Prosper rebuilds. Prosper is an AI-native platform that runs the voice-heavy work for clinic operations end-to-end: appointment scheduling, insurance eligibility and benefits verification, and patient billing. What sets it apart is the breadth of capabilities. Existing voice automation is built for simple operations with rigid rule trees that ultimately allow you to only automate a small portion of this work. Prosper is built for the combinatorial complexity of large specialty care groups: 10+ locations, 100+ appointment types, 1000+ insurance plan combinations. It handles patient, provider, payor, pharmacy, and pharma conversations in one system, writing structured data into the practice's tools, navigating payor portals when there's no API to call, and escalating work to human staff only when an AI agent can't finish it. What comes out the other side, much sooner, is a financially cleared patient appointment. Last generation voice agents were never truly end-to-end service providers. Each tool picked a lane and stopped there. But healthcare administrative staff don't work like this - they'll only trust a platform that can be their first line of defense for any phone call they handle. We have been looking for a team building this; we have been looking for Prosper. In under two years, Prosper has gone from launch to a growing roster of leading specialty practices across the country, and signed channel partnerships with major EHR and RCM vendors that put it in front of hundreds of thousands of providers and millions of phone calls. Revenue is compounding fast, and the value shows up where it counts: a jump in scheduled and paid appointments, without further burdening clinic staff. In a market full of voice AI demos, Prosper is one of the few converting interest into business-critical, sticky deployments. At the heart of all of this are co-founders Xavier and Josep, who have felt every pain point Prosper solves. Xavier grew up inside his family's medical practice before going on to run large-scale call center operations at Handy (acquired by Angi, NASDAQ: ANGI). Josep is a former MIT CSAIL researcher who led product at CoverWallet (acquired by Aon, NYSE: AON), where he digitized distribution for some of the largest insurance lines in the U.S. They understand provider operations, call center logistics, and insurance company workflows from the inside -- and they've assembled a deeply technical team with whom they are deploying Prosper into the world. We led Prosper's $30M Series A because fixing healthcare's phone call crisis is how you rebuild the administrative core of healthcare globally. Every scheduling, eligibility, and billing conversation is a consequential decision point -- care happens or it doesn't, the provider gets paid or doesn't -- and Prosper is the essential infrastructure at the center of it all.

Prosper AI Raises $30 Million to Automate the Patient Journey | PYMNTS.com

The New York-based company has built an AI platform that handles patient scheduling, insurance verification and billing in a single workflow. It operates across more than 150,000 healthcare providers spanning more than 25-plus medical specialties, with integrations into athenahealth, ModMed, Veradigm, ECW and ImagineSoftware, among other EHR platforms. The funding round, which included participation from Base10 and continued support from Emergence Capital, Y Combinator and Company Ventures, comes after a period of rapid growth. Since its last funding announcement six months ago, Prosper AI said, its revenue grew fivefold and the company added more than 40 healthcare organizations as customers. The platform now powers more than $1.3 billion in patient care and wins 80% of competitive evaluations, according to the company. Prosper AI positions itself as a response to the fragmentation that has historically defined healthcare administration. Scheduling, insurance verification and patient billing have typically been handled by disconnected teams using separate tools -- a structure the company said generates more than $450 billion in annual administrative waste. The platform answers patient calls, schedules appointments directly in the EHR, verifies insurance benefits, automates patient billing and contacts insurers when additional information is needed. Providers using the platform have reduced administrative costs by more than 40%. The opportunity Prosper AI is targeting remains largely untapped. PYMNTS Intelligence data show that only 5% of healthcare firms currently use AI for customer journey orchestration, even as 60% have adopted AI for customer service chatbots. That gap between narrow automation and end-to-end workflow management is where Prosper AI is competing. Customers include private equity-backed outpatient groups such as Preferred Dermatology, health systems such as Jackson Memorial Hospital -- the second-largest hospital in Florida -- and athenahealth, which selected Prosper AI for internal voice AI workflows after evaluating multiple competing platforms. ImagineSoftware, which serves more than 100,000 physicians and processes more than $65 billion in claims annually, also selected Prosper AI following a competitive evaluation. Jay Rughani, partner at Andreessen Horowitz, said the firm was drawn to the breadth of Prosper AI's ambition. "They want to eliminate every administrative friction point between a patient and the care they need," Rughani said. Prosper AI said it will use the new funding to expand its engineering and customer-facing teams, deepen integrations across major EHR platforms and accelerate adoption across provider groups and health systems. The company was founded in 2023 by Xavier de Gracia and Josep Mingot.