What is AI medical audit?
AI can assist administrative, clinical and financial review of claims and supporting records. Findings require evidence, contractual and regulatory checks before a human decision.
FAQ · AI medical audit
AI medical-audit FAQ
Short answers to the questions payer, EPS, insurer and medical-audit teams ask about AI medical audit in Colombia.
Arkangel AI
What is Arkangel AI?
Arkangel AI offers medical evidence search and chart and document review workflows. Confirm institutional claims-audit scope, rules, sources and available configuration with the team.
How does Arkangel AI use Resolución 3047 de 2008?
Resolución 3047 is a historical reference. The official compilation records repeal from April 1, 2026. Check 2284 and 2335 de 2023, amendments and transition based on claim dates and type; do not automatically apply historical codes to current claims.
Does AI medical audit replace auditors?
No. An auditor must review documentation, contracts, exceptions and applicability before accepting or communicating an objection. Assisted review does not replace professional judgment.
What does the clinical layer review?
It examines clinical justification in context. In the historical manual, pertinence is general concept 6; concept 2 is tariffs. System suggestions require evidence and human review.
What is the innocence rule in medical audit?
Distinguish missing information from a confirmed breach. This is a review principle, not a universal legal rule: missing required documentation can support an objection or return, depending on the rules, contract and exceptions.
Which files can Arkangel AI analyze?
Confirm formats and connectors for the contracted workflow. Use synthetic sample documents to validate reading, extracted fields, failures and traceability before introducing real data.
How is Arkangel AI different from generic fraud detection?
Compare supporting evidence, exceptions and human review, rather than only a risk score. Verify each provider’s scope for the specific use case and market.
Can Arkangel AI work with SAP or other ERP systems?
Integration with SAP or another ERP requires checking the product, version, permissions, interfaces and scope. This page does not establish a certified standard integration or automatic regulatory adjudication.
Is Arkangel AI designed for Colombia only?
The brand supports several healthcare uses. Glosas, EPS, CUPS and RIPS on this page refer to Colombia; US ICD-10-CM, CPT and MS-DRG are not automatic equivalents.
See Arkangel AI on your audit workflow
Talk to Arkangel AI about AI medical audit for Colombian payer, EPS and insurer teams.
Talk to the teamOfficial sources · editorial update 2026-10-05