Submission Instructions

Leon Health Plan has partnered with Availity to service your electronic data interchange (EDI) transactions and to offer a direct connection to our plan for the following health transactions.

Availity is now live as an EDI gateway for the following transactions:

LIVE – Electronic claim submissions (837 P/I)
LIVE – Electronic remittance advices – ERA (835)
(enrollment with Availity required)
LIVE – Claims Status Inquiry & Response (276/277)
LIVE – Requests and responses for eligibility and benefits (270/271)

The Payer Name and ID:
Payer Name: Leon Health Plan
The payer ID: A3565

What you can do now
Complete the steps below:

Register with Availity to get a customer account.

Go to www.availity.com and click Register.
Follow the attached instructions to enroll to receive 835s from Leon

If the providers need additional assistance please contact
Availity at 1-800-282-4548

Leon Health requires paper claims to be filed on a CMS-1500 or UB- 04 form with accurate and valid information. All required sections of the CMS -1500 or UB- 04 must be completed. Paper claims received on non-standard claim forms will be returned to the provider for resubmission on the appropriate claim form.

Leon Health will not accept super-bills or similar submissions as valid claims.

Preferably, claims should be computer generated or typed.

Claim Signature Requirements
When filing a paper claim, the physician or provider’s handwritten signature (or signature stamp) must
be in the appropriate block of the claim form (box 31).

Claims prepared by computer billing services or office-based computers may have “Signature on File” in the signature block along with the printed name of the provider. For claims prepared by a billing service, the billing service must retain a letter on file from the provider authorizing the service.

Where to Submit Paper Claims
For paper claims from physician and ancillary providers, mail to:

Leon Health, Inc.
Attn: Claims Department
P.O. Box 61265
Phoenix, AZ 85082-1265

If a provider wishes to have proof of receipt by individual claim, the provider must request this and
must include a list of the exact claims enclosed in the package.

The list should include the following information:

• Member Name;
• Member ID;
• Date(s) of Service; and
• Billed Amount Total

Leon Health will verify that the specifically listed claims are enclosed in the package and return confirmation to the provider via mail.

Claims submission via email or fax is not acceptable.

If you have any additional questions, please contact our Claims Department at 305-718-2840 or via email at ProviderServices@leonhealth.com.