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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