Power BI
AR Forecasting
2026
7 min read
Healthcare AR Forecasting & Payer Benchmarking Power BI: $1.8M Underpayments Recovered
Industry
PE-Backed RCM Services
Region
East Coast, USA
Billing Systems
AdvancedMD · Athenahealth
Platform
Microsoft Fabric · Power BI Premium
Numlytics built healthcare AR forecasting Power BI dashboards and a payer benchmarking intelligence platform for a PE-backed revenue cycle management company achieving 93% accuracy at the 30-day forecast horizon, recovering $1.8M in systematic payer underpayments in year one, reducing average AR days from 48 to 33, and growing average new contract value 4× by enabling enterprise-grade cash flow reporting for provider clients.
The Challenge: Flying Blind in Payer Contract Negotiations
A PE-backed RCM services company managing billing for multi-specialty physician groups had no payer benchmarking analytics capability. Payer contract renegotiations were conducted without data; the company had no visibility into which payers were systematically underpaying, on which CPT codes, or by how much. Simultaneously, provider clients were demanding cash flow reporting that competitors were already offering through live healthcare AR forecasting Power BI portals.
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No payer benchmarking: Contract renegotiations conducted without data, no system to compare actual payments against contracted rates at the CPT code level, meaning systematic underpayments went undetected
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No AR forecasting: Provider clients had no visibility into projected collections, losing enterprise pitches to competitors who could show 30/60/90-day cash flow forecasts in Power BI dashboards
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Manual investor reporting: The 40+ hour monthly investor reporting pack was assembled manually across 4 sites and 3 billing systems consuming senior staff time that should have been applied to collections
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Fragmented billing data: Claims data spread across AdvancedMD, Athenahealth, and manual Excel trackers with no consolidated view, making any analysis a multi-hour exercise in data wrangling.
Revenue leakage: Without payer underpayment detection, the company was systematically under-collecting on BCBS Illinois and Cigna HMO, both payers were found to be underpaying on Modifier 25 and outpatient surgery CPT codes. $1.8M in underpayments had gone undetected before Numlytics surfaced them.
The Numlytics Solution:
Numlytics built two integrated modules on Microsoft Fabric - a healthcare AR forecasting Power BI engine and a payer benchmarking intelligence layer, both connecting to existing billing systems without disrupting any operational workflows.
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Unified Data Pipeline - AdvancedMD and Athenahealth Integration
Numlytics built Azure Data Factory pipelines ingesting claims data, ERA/835 remittance files, and eligibility data from AdvancedMD and Athenahealth into a centralised Microsoft Fabric OneLake warehouse. Automated reconciliation catches discrepancies before they become billing patterns. This unified data foundation makes accurate revenue cycle accounts receivable forecasting possible for the first time.
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Payer Benchmarking Analytics CPT-Level Payment Analysis
Numlytics built a Power BI payer benchmarking layer that compares each payer's actual payments against contracted rates at the individual CPT code level, surfacing systematic underpayments by payer, code, provider, and site. BCBS Illinois and Cigna HMO were flagged immediately for Modifier 25 and outpatient surgery underpayments. The payer underpayment detection module alone recovered $1.8M in year one.
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30/60/90-Day AR Forecasting Power BI Model
Numlytics built the healthcare AR forecasting Power BI model using historical payer payment velocity, seasonal collection patterns, and claim aging data from Microsoft Fabric. The model achieves 93% accuracy at the 30-day horizon accurate enough for banking covenant compliance and board cash flow presentations. Provider clients now see live 30/60/90-day collection forecasts in their branded Power BI portals.
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Investor and Board Reporting Automation
The 40+ hour monthly investor reporting pack previously assembled manually across 4 sites and 3 billing systems is now generated automatically via Power Automate from Microsoft Fabric. Leadership reviews it in under 2 hours. Medical billing Power BI dashboard data populates investor decks, QBR presentations, and banking covenant reports with no manual intervention.
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Payer Contract Intelligence for Renegotiations
Numlytics built a contract intelligence module tracking each payer's payment performance trend over time, giving the commercial team precise, data-backed evidence for contract renegotiations. In the first renewal cycle post-launch, the team used Numlytics payer benchmarking data to negotiate an improved BCBS contract term worth $400K annually.
The Results
$1.8M
Underpayments Recovered
BCBS and Cigna systematic underpayments identified and disputed.
31%
AR Days Improvement
Average AR days reduced from 48 to 33 through payer targeting.
93%
Forecast Accuracy
30-day AR forecasting Power BI model - banking covenant grade
4×
Contract Value Growth
Average new enterprise contract value vs prior year baseline.
40hrs
Reporting Eliminated
Monthly investor pack automated, from 40 hours to 2 hours.