Member Resources

Member Resources

Grievances and Appeal (Reconsiderations and Redeterminations) Information
How to File a Grievance and/or Appeal

You or your authorized representative may file a grievance or appeal request either verbally or in writing.

To file a Grievance and/or Appeal, you can contact SOLIS Health Plans in one of these ways:
  • By phone:

    Call SOLIS Member Services department at 1-844-447-6547, TTY 711

    8 a.m. to 8 p.m. seven days a week from Oct. 1 – March 31

    8 a.m. to 8 p.m. Monday-Friday from April 1 - Sept. 30

  • Fax or mail the form:

    If you prefer, you can download a copy of the form below and fax or mail to the below:

    • Fax number:1-833-615-9263

    • Mailing address:

      SOLIS Health Plans, Inc.

      PO Box 524173

      Miami, FL 33152

You can also file a complaint on Medicare.gov website


Click here for instruction on How to File a Grievance or Appeal


Request for Redetermination of Medicare Prescription Drug Denial Form click here


Grievance and Appeals Request Form click here

How to Appoint a Representative

In order for SOLIS to process a Grievance or/and Appeal request from someone other than you (the member), your physician, your prescribing physician (Part D), or other prescriber (Part D), we must have authorization from you. You may appoint any individual as your representative by sending us an Appointment of Representative form signed by both you and the representative. A representative who is appointed by the court or who is acting in accordance with state law may also file a request for you after sending us the legal representative form. You will not need to complete an Appointment of Representative Form if you provide an equivalent written notice or other legal representation document with your request.


Instructions on how to Appoint a Representative click here


You also can get the Appointment of Representative form on CMS's website.


If you have any questions, please call SOLIS Member Services department at 1-844-447-6547, TTY 711,

8 a.m. to 8 p.m. seven days a week from Oct. 1 – March 31

8 a.m. to 8 p.m. Monday-Friday from April 1 - Sept. 30


Appointment of Representative Form click here


Contact numbers for members and physicians who have questions and need to inquire about the status of the Grievance and/or Appeal processes


Members:

Please call the SOLIS Member Services department at 1-844-447-6547, TTY 711

8 a.m. to 8 p.m. seven days a week from Oct. 1 – March 31

8 a.m. to 8 p.m. Monday-Friday from April 1 - Sept. 30


Provider/Physicians:

Please call the SOLIS Provider Services department at 1-833-615-9259, Monday to Friday, 8 a.m. to 5p.m. Our fax number is 1-833-615-9263.


How to Obtain an Aggregate Number of Grievances, Appeals and Exceptions Filed with SOLIS Health Plans click here


You can also find detailed information regarding grievances and the appeals process in the SOLIS Evidence of Coverage (EOC). Links to the EOC can be found on the Our Plans page.