Salmona: traceable medical billing review architecture for Colombia

June 30, 2026PreprintResearch Square 2026 · 1 min read

Audit layers: 3; Administrative, clinical necessity and financial-contractual; architectural description, not efficacy results
Documented rules: 98; 27 administrative, 29 clinical necessity and 42 financial-contractual rules

Methodological study of Salmona: three medical billing audit layers, rule-level traceability and human governance. Preprint without empirical validation.

Katherine Monsalve, Natalia Castaño-Villegas, Fiorella Ramirez, Elmer Raúl Escandón, Jose Zea, Laura Velásquez

Study overview

This descriptive methodological study documents Salmona, Arkangel AI's rule-grounded medical billing review architecture for Colombian healthcare reimbursement. It draws on technical documentation and the applicable Colombian regulatory framework.

Version 1 was posted on Research Square on June 30, 2026. It is a preprint under review, not yet peer reviewed by a journal. No patient data were collected and no empirical validation was conducted.

Three traceable audit layers

Administrative: 27 DAMA-UK rules.
Clinical necessity: 29 PERT-CLIN rules examining evidence supporting billed care.
Financial and contractual: 42 FIN-CTR rules.

Each rule returns pass when compliance is supported, fail when a violation is supported, or n/a when the required information is absent. Missing documentation does not automatically become a billing objection.

Human governance

A consolidation layer reconciles findings per invoice item, assigns objection causals under Technical Annex 6 of Resolution 3047 of 2008 and calculates objected amounts under a financial integrity invariant. A human auditor reviews findings, requests corrections through comments and explicitly initiates report delivery to the provider.

Limitations and disclosure

This is an architectural description, not evidence of accuracy, savings, reduced billing objections or clinical impact. Validation with real claims remains future work. The authors also describe potential provider-side pre-submission validation and structured responses to objections. All authors declare employment at Arkangel AI, which developed Salmona. The manuscript is licensed under CC BY 4.0.

Original source

Read the Research Square preprint · DOI: 10.21203/rs.3.rs-9819774/v1

Results at a glance

The headline numbers from the paper, in plain language.

Metric	Value	What it means
Audit layers	3	Administrative, clinical necessity and financial-contractual; architectural description, not efficacy results
Documented rules	98	27 administrative, 29 clinical necessity and 42 financial-contractual rules

How to cite

Katherine Monsalve, Natalia Castaño-Villegas, Fiorella Ramirez, Elmer Raúl Escandón, Jose Zea, Laura Velásquez. Salmona: A Multi-Domain Architecture for Traceable Medical Billing Review in Colombian Healthcare. Research Square. 2026. https://doi.org/10.21203/rs.3.rs-9819774/v1

@article{monsalve2026salmona,
  title     = {{Salmona: A Multi-Domain Architecture for Traceable Medical Billing Review in Colombian Healthcare}},
  author    = {Katherine Monsalve and Natalia Castaño-Villegas and Fiorella Ramirez and Elmer Raúl Escandón and Jose Zea and Laura Velásquez},
  journal   = {Research Square},
  year      = {2026},
  doi       = {10.21203/rs.3.rs-9819774/v1},
  url       = {https://www.researchsquare.com/article/rs-9819774/v1},
  note      = {Preprint}
}