Claim Appeals

Provider Appeal Rights (Non-Contracted Providers):

Providers not participating with Leon Health Advantage Plan have the right to appeal. You may file your appeal in writing within 60 calendar days after the date of the remittance advice. The time can be extended if you can provide evidence for what prevented you from meeting the deadline. For us to review your appeal, we will need your completed signed Waiver of Liability Statement. To obtain a Waiver of Liability form, download the document from our website.

We can also mail you a form that includes the timeframe for returning it to us. To request this, please contact Leon Health Provider Services Center at the phone number listed below. Once we receive the completed
forms, we will give you a decision on your appeal within 60 calendar days.

Provider Services: (833) 373-5366

You may mail your written appeal to:

Leon Health, Inc.
Appeals and Grievances Department
P.O. Box 668230
Miami, FL. 33166

You may also fax your appeal along with the Waiver of Liability Statement to:
Leon Health, Inc. Claims Appeals Department Fax #: (305) 718-2871


Provider Appeal Rights (Contracted Providers):

As a contracted provider of the plan you have the right to file a claims dispute if you believe that you have been paid less than the amount you are entitled to for the rendered services. You must submit the dispute within the timeframe allotted in your contract. Failure to file the dispute within the required timeframe will result in a denial.

Please submit all claims disputes to our Claims Appeals Department:

Leon Health, Inc.
Appeals and Grievances Department
P.O. Box 668230
Miami, FL. 33166

Member Services Department Fax #: (305) 718-2830
Claims Appeals Department Fax #: (305) 718-2871

If you have any additional questions please call our Member Services Department at (844) 969-5366. Leon Health’s hours of operation are 8 a.m. to 8 p.m., seven days a week from October 1st through March 31st and Monday through Friday the rest of the year.