Submitter Not Approved Rejection
For All Submitters
Below are some common reasons for receiving an A8:496:85 rejection on a 277CA report with the message, "Submitter Not Approved." Beside each reason are suggestions of what to check when working to resolve the issue.
Reason |
What to Check |
837 Transaction Not in Production |
- Log into EDISS Account and verify 837 transaction is registered in Production.
- If sending direct via a Network Service Vendor, make sure the "I will and/or" option is selected for the 837 transaction.
- If sending through a Billing Service or Clearinghouse, make sure the correct vendor is selected for the 837 transaction.
|
Rendering NPI Sent as Billing NPI (Professional Lines of Business Only) |
- Verify the NPI used in loop 2010AA NM109 is the billing NPI.
- Note: The rendering NPI would be located in loop 2310B NM109, if different from what is sent in 2310B NM109.
|
Tax ID Not on File with Payer |
- Verify the Tax ID in loop 2010AA REF is valid for the NPI.
|
Incorrect Submitter ID |
- Medicare JF and Commercial: The GS02 and loop 1000A NM109 need to reflect the Submitter ID associated with the billing NPI in Connect.
- Medicare JE: The ISA06, GS02, and loop 1000A NM109 should all match. They should contain either the direct Submitter ID/billing group number, or should all indicate the vendor's Submitter ID.
|
Incorrect Payer ID |
|
Message Sent:
November 2, 2021