Prosper's $108 billion uncollected-care claim shrinks by half under its own no-show and denial rates
The a16z-backed voice-agent vendor says specialty practices leave $125,000 per physician uncollected each year. Run the report's own no-show, denial and collection rates back through its flagship example and the number shrinks by roughly half, and most of what remains is a transfer from payers and patients, not new money.
Richard Tang · 2 min read
Prosper AI, the a16z-backed voice-agent vendor for specialty practices, published research on October 13 claiming US dermatology, ophthalmology, GI, OB-GYN, primary care and orthopedic practices leave $108 billion a year uncollected, about $125,000 per physician across four levers 1. Its investor a16z amplified the number the same day 2. Run the report's own rates back through its own flagship example, and the headline does not survive.
The flagship example shrinks under the report's own rates
The flagship is Piedmont Plastic Surgery and Dermatology in North Carolina: 37 providers, 17% more appointments booked in August year over year, 3,315 extra bookings the report values at $1.3 million using MGMA's $392 dermatology visit 2. But the same report measures an 18.8% average no-show rate, a 10% first-submission denial rate, and practices collecting only 39% of what patients owe at the visit 2.
Apply those to the extra bookings and the revenue that survives to collection is roughly $740,000 to $950,000, not $1.3 million. The $108 billion is four best cases added up with no netting between them.
Calls are the biggest lever; the other three are money already owed
Data
| Per physician per year | |
|---|---|
| Calls and scheduling | $44,800 |
| Re-engaged patients | $37,400 |
| Prevented denials | $28,500 |
| Collected balances | $14,100 |
Most of the four levers is money already owed
Three of the four levers, prevented denials, collected balances and re-engaged lapsed patients, are money already owed to someone 1. Practices control them, and that is the honest part of the pitch: answering every call and verifying benefits before a visit is real work, and Prosper's Piedmont result shows the capability is live 13.
But in a 2027 where Medicare Advantage moves 3.2 million enrollees into new plans, raises average drug-plan deductibles 23% and lifts out-of-pocket maximums 9% 5, while a 2.5% CMS wRVU haircut on roughly 7,700 codes lands on procedural specialties on January 1 4 and the temporary 2.5% Medicare boost dies at year end 1, most of that $125,000 is a transfer from payers and patients to practices, not growth anyone is creating.
The gap is real, and so far AI has not closed it
The profession's own new data says the gap is real but unclosed: MGMA's latest compensation report finds only 46% of practice leaders say AI made providers more productive 4. Several said AI cut documentation time without adding visits or revenue.
Prosper has raised a $30 million Series A led by a16z and sits in 100+ groups 6. The lesson for investors: discount the market-size slide to its own no-show math, and pay for the builder who closes the collection gap, which Prosper is showing it can do, one booked call at a time.
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