Prosper AI

by Prosper AI  · Based in United States →AI Voice Agents for Patient Access & Revenue Cycle Management in Healthcare
Family Medicine Mental & Behavioral Obstetrics & Gynecology

Paid/enterprise

Overview

Prosper AI offers specialized AI voice agents designed to automate critical patient access and revenue cycle management (RCM) workflows for healthcare organizations. This platform aims to alleviate the significant administrative burden faced by medical practices, hospitals, and billing companies, which traditionally involves extensive phone-based interactions with patients and payers. By deploying AI-native voice agents, Prosper AI delivers near-instant call pickup, high containment rates, and substantial reductions in operational costs.

The AI agents are trained specifically on healthcare workflows, enabling them to handle a wide array of tasks that typically consume staff time. These include inbound and outbound patient scheduling, rescheduling, cancellations, appointment reminders, and patient intake processes. For financial operations, Prosper AI automates billing inquiries, patient balance reminders, payment collection, insurance eligibility and benefits verification, prior authorization initiation and follow-up, and claims status checks. The system integrates deeply with existing Electronic Health Record (EHR) and Practice Management (PM) systems, ensuring real-time data synchronization and structured documentation.

Prosper AI differentiates itself from generic AI solutions by being purpose-built for the complexities of healthcare. Its agents can navigate intricate payer IVR systems with high accuracy, wait on hold, and extract necessary information, significantly speeding up processes like benefits checks and prior authorizations. The platform emphasizes enterprise-grade security and compliance, adhering to HIPAA and SOC 2 Type II standards, and offers robust integration capabilities with over 80 major EHRs. With a focus on rapid deployment and customizable workflows, Prosper AI empowers healthcare teams to improve patient experience, enhance operational efficiency, and redirect staff efforts towards direct patient care.

Reviewed by Pouyan Golshani, MD — Interventional Radiologist

Key Features

  • AI-powered voice agents
  • 24/7 inbound/outbound scheduling
  • Automated eligibility & benefits verification
  • Prior authorization initiation & follow-up
  • Claims status checks
  • Billing inquiries & payment collection
  • Patient re-engagement campaigns
  • AI-powered quality assurance
  • Multilingual reminders
  • Intelligent switchboard & call routing

Use Cases

  • Automating patient scheduling and reminders
  • Streamlining insurance eligibility and benefits checks
  • Managing prior authorizations for treatments and medications
  • Handling patient billing questions and collecting payments
  • Automating claims follow-ups with payers
  • Improving patient intake and re-engagement campaigns

What Physicians Need to Know

Key Capabilities
Automates end-to-end patient and payer phone workflows including scheduling, rescheduling, cancellations, patient registration, referral coordination, appointment reminders, insurance eligibility verification, benefits checks, prior authorization calls, pharmacy/payer communications, prescription refill requests, post-visit follow-ups, claim status checks, billing inquiries, and payment-related calls. It can navigate complex payer IVRs and extract necessary information.
Clinical Utility
Reduces administrative burden on healthcare staff, improves patient access with 24/7 availability and reduced hold times, streamlines revenue cycle management, decreases claim denials, and accelerates collections. It frees up staff to focus on higher-value patient care and can assist with nurse triage routing and intent detection for clinical queries.
Integration Options
Offers native integrations with over 80 EHRs (e.g., Epic, athenahealth, Cerner, eClinicalWorks, MEDITECH, NextGen) and practice management systems via API, SFTP, or file-based ingest. It also integrates with clearinghouses, CRMs, and telephony systems (e.g., Genesys, Twilio, NICE CXone).
Compliance Status
HIPAA compliant with a signed Business Associate Agreement (BAA). Annually audited to SOC 2 Type II standards. Ensures data encryption in transit (TLS) and at rest (AES 256), along with access controls, monitoring, audit trails, and logging. Supports both cloud and on-premise deployment options.
Pricing Model
Pricing is straightforward and based on the usage of the Prosper platform. Custom pricing options are available for high-volume customers and partnerships.
User Experience
Features AI-powered quality assurance that automatically reviews every call for accuracy and compliance, providing real-time analytics. Call flows are customizable without requiring engineering support. The system is designed for empathetic automation and intelligent handoff to human agents when complex issues arise. Multilingual support is also available.
Support Quality
Each customer is assigned a dedicated AI Agent Manager who serves as the primary operational owner, responsible for ongoing performance monitoring, issue resolution, and continuous optimization of the AI agents.
Implementation Complexity
Follows a phased, outcome-driven implementation approach. Initial setup can be as quick as 1-2 days using spreadsheets or SFTP, with full API/EHR integration typically taking a few weeks (e.g., 3 weeks to launch). The system operates on top of existing EHRs and tools, rather than replacing them.
Evidence Base
Reported outcomes include approximately 50% call containment, ~40% cost reduction, a 12% increase in scheduled appointments, and a 50-70% automation rate for inbound calls. The platform achieves 99% accuracy in navigating payer IVRs and offers sub-two-hour turnaround times for complex benefit checks.
Physician Tip

Prosper AI is particularly beneficial for offloading high-volume, repetitive administrative tasks, freeing up clinical staff for direct patient care. Consider starting with specific pain points like appointment scheduling or insurance verification to see immediate ROI. Leverage its 24/7 availability to enhance patient access and reduce after-hours call burdens. Ensure a clear escalation path is established for complex clinical queries that require human intervention. Utilize the AI-powered QA and analytics to monitor performance and identify areas for continuous improvement in your practice's workflows.

Prosper AI boasts extensive integration capabilities with over 80 EHR and practice management systems, utilizing APIs, SFTP, or file-based exchanges. This deep integration ensures seamless data flow between the AI agents and your existing clinical and operational systems, minimizing manual data entry and maintaining data consistency. Verify specific EHR compatibility and discuss the preferred integration method with Prosper AI during the planning phase to ensure optimal setup for your practice.

Details

Category Medical Billing & RCM, Medical Phone & Communication, Prior Authorization
Pricing Paid/enterprise Custom pricing based on usage and specific workflows; enterprise solutions available.
DeploymentCloud/hybrid
API Available Yes
Data Export Yes
LanguagesEnglish, other languages (multilingual)
Training Yes
Target SizeSolo to large health systems
Compliance
BAA Available Yes AI-estimated
HIPAA Compliant Yes AI-estimated
FDA Status Unknown AI-estimated
SOC 2 Yes AI-estimated
Integrations
EHR Allscripts, Athenahealth, Cerner, DrChrono, eClinicalWorks, Elation, Epic, MEDITECH, ModMed, NextGen
Specialties Family Medicine, Mental & Behavioral, Obstetrics & Gynecology, Primary Care & Family

Social Proof

CustomersHandles hundreds of thousands of calls daily for dozens of providers, including a Providence-affiliated hospital network, a Fortune 50 pharma hub, a 30,000-employee medical billing company, and an EHR system with over 100,000 medical providers.
Notable
Providence-affiliated hospital networkFortune 50 pharma hubSynergy Healthcare AssociatesNortheast OB/GYN

Support & Reliability

Training Provided Yes

What the Web Says

Prosper AI, particularly its product 'Prosper for Providers,' is generally well-received for its ability to automate prior authorization processes, aiming to reduce administrative burden and improve efficiency for healthcare providers. Reviews highlight its potential to free up staff time and accelerate patient access to necessary treatments, though some concerns exist regarding implementation and the nuances of AI in complex healthcare workflows.

Overall: Positive

Strengths

  • Automates prior authorization, saving significant administrative time for staff.
  • Reduces manual paperwork and phone calls associated with prior authorizations.
  • Accelerates the prior authorization process, leading to faster patient access to care.
  • Integrates with existing EHR systems, streamlining workflows.
  • Offers a user-friendly interface, making it relatively easy to adopt.
  • Improves efficiency and reduces operational costs for healthcare practices.

Limitations

  • Initial setup and integration can be complex and time-consuming.
  • Reliance on AI may raise concerns about accuracy in highly nuanced medical cases.
  • Potential for 'black box' decision-making, where the AI's reasoning isn't fully transparent.
  • Subscription costs might be a barrier for smaller practices.
  • Requires ongoing monitoring and human oversight to ensure compliance and accuracy.
  • Some users report a learning curve for staff to fully utilize all features.

Based on reviews from: G2, Capterra, Reddit (healthcare IT discussions), Healthcare IT News, Physician reviews (via industry forums), Tech review sites (focused on healthcare solutions)

Last updated: 2026-07-24

Ratings & Reviews

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Press & Coverage

Fierce Healthcare
Andreessen Horowitz backs Prosper AI's $30M series A round - Fierce Healthcare
Prosper AI secured $30 million in Series A funding led by Andreessen Horowitz to expand its agentic AI platform, which automates administrative tasks across the patient journey, including scheduling, insurance verification, and billing.
2026-06
Becker's Hospital Review
Prosper AI raises $30M amid growth spree - Becker's Hospital Review
Prosper AI, a New York-based company, raised $30 million in Series A financing, reporting a fivefold revenue increase and an expanded customer base of over 150,000 healthcare providers across 60 organizations.
2026-06
Disaster Recovery Journal
Prosper AI Raises $30M from Andreessen Horowitz to Scale the First AI Platform to Run the Entire Patient Journey - Disaster Recovery Journal
Prosper AI announced a $30 million Series A funding round, highlighting its rapid growth with a 5x revenue increase and expansion to over 150,000 healthcare providers, managing over $1.3 billion in patient care.
2026-06
PYMNTS.com
Prosper AI Raises $30 Million to Automate the Patient Journey | PYMNTS.com
Prosper AI secured $30 million in Series A funding to advance its AI platform, which integrates patient scheduling, insurance verification, and billing, aiming to reduce administrative waste in healthcare.
2026-06
Forbes
How Prosper AI Hopes To Shake Up U.S. Healthcare For Good - Forbes
Forbes highlights Prosper AI's $30 million funding and its comprehensive AI platform designed to manage the entire patient interaction process, from scheduling to billing, addressing the significant administrative costs in US healthcare.
2026-06
Prosper AI (Blog)
AI Prior Authorization in 2026 - Prosper AI
This article discusses the role of AI in streamlining prior authorization processes in 2026, noting emerging regulatory frameworks and the potential for AI to automate and improve efficiency while highlighting the risks of unregulated AI.
2026-02
Prosper AI (Website)
Automated Prior Authorization Software | Prosper AI
Prosper AI offers automated prior authorization software with healthcare-tuned voice agents that handle medical and pharmacy prior authorizations, benefits verification, and scheduling, emphasizing compliance with new CMS regulations.
2026-07
Prosper AI (Blog)
Prosper AI vs Assort Health Review (July 2026)
This review compares Prosper AI and Assort Health, highlighting Prosper AI's comprehensive voice AI agents that automate a full range of patient and payer phone workflows, including scheduling, benefits verification, prior authorization, and billing.
2026-07

Videos

Product demos, reviews, and walkthroughs for Prosper AI.

View all on YouTube

Frequently Asked Questions

Prosper AI automates high-volume administrative calls related to revenue cycle management, including patient scheduling, eligibility and benefits verification, prior authorizations, and claims status checks. It handles inbound billing questions and can even follow up on claim denials by calling payers directly.
Prosper AI is built for healthcare, ensuring HIPAA compliance with a signed Business Associate Agreement (BAA) and SOC 2 Type II attestation. It employs technical safeguards like encryption in transit and at rest, role-based access controls, and often utilizes zero data retention policies for sensitive information to minimize risk.
Prosper AI offers straightforward pricing based on usage of its platform, with custom pricing available for high-volume customers and partnerships. While specific figures aren't publicly detailed, the aim is to reduce operational costs and improve cash flow by automating repetitive tasks, potentially leading to significant savings and increased revenue.
While Prosper AI excels at automating repetitive phone-based administrative tasks, its primary focus is on these specific workflows. It augments human staff rather than replacing them, meaning complex or highly nuanced patient interactions requiring deep human empathy or clinical judgment would still necessitate human intervention.
Prosper AI integrates seamlessly with over 80 EHR and PM systems, including major platforms like Epic, AthenaHealth, Cerner, and NextGen. This integration allows the AI agents to read patient data and write structured results back into the patient record, ensuring a smooth and automated workflow.
While Prosper AI is a specialized voice AI platform for healthcare RCM, alternatives for broader AI-powered call center solutions or RCM automation include Nextiva, Talkdesk, JustCall, Retell AI, and CallRail. Other RCM-specific solutions like Optum360 and Solventum also offer AI-enhanced coding and processing.
Practices can expect significant improvements in efficiency, with reported automation rates of 50-70% for inbound calls, leading to reduced administrative workload and errors. This translates to potential cost reductions of over 50% and revenue increases of over 20% due to faster payments, fewer denials, and improved appointment scheduling.

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Suggest an Edit → | Last Verified: 2026-04-24 | First Added: 2026-04-24
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