/01
ClaimsReview the case. Keep the context.
Organize the medical record, invoice, and supporting documents. Give auditors the source behind each finding.
AI medical claims audit and payment integrity for insurers in Latin America
Every claim finding, with its rule and its evidence.
Your auditor decides.
organize the claim evidencewhile your team helps members
98 deterministic rules (27 administrative, 29 clinical, 42 financial) review each claim against the medical record, the bill and the contract. Anything Arkangel can’t confirm is marked “not verified”. It never rejects a payment on its own.
From the bill to the decision.
/02
PaymentsCatch tariff and contract mismatches before you pay.
Compare billed items with the applicable contract and tariff. Surface missing support and differences for your team to review.
/03
DecisionsExplain the decision from its source.
Keep findings, exceptions, and supporting evidence together. Your auditors review and approve the response and payment decision.
Resources
How AI-assisted glosa audit works: the method (in Spanish)
Glosa codes: crosswalk from Resolución 3047 to Resolución 2284 de 2023 (in Spanish)
Administrative, clinical, and financial audit in healthcare: why the three domains cannot be reviewed with the same system (in Spanish)
How to evaluate an AI tool for medical audit: criteria for insurers in LATAM (in Spanish)
Frequently asked questions
- How does Arkangel AI help health insurers audit claims?
- Arkangel AI runs a complete audit of claims and medical bills based on scientific evidence, with deterministic rules and human review. When a finding cannot be verified it is marked as not verified, never rejected automatically. The auditor makes the final decision.
- How can an insurer check how Arkangel AI works before a pilot?
- By looking at the system itself: 98 deterministic rules (27 administrative, 29 clinical and 42 financial), the evidence behind every finding, "not verified" when there is no certainty, and the human auditor making the final decision. We do not publish client data; a pilot measures results on your own claims.
- Is Arkangel AI secure enough for patient data?
- Arkangel AI is ISO 27001:2022 certified, with 70+ security controls, penetration testing and continuous monitoring via Vanta. Enterprise plans include HIPAA compliance and a BAA. The details are in the Trust Center at compliance.arkangel.ai.
- Where is Arkangel AI available?
- Arkangel AI works in English, Spanish, Portuguese and French and is used by healthcare teams in Latin America and the United States. In the EU it is available under specific conditions with an Enterprise license.
Contact Us
Let’s talk about how Arkangel can help your team.