Skip to content | Skip to navigation


Submitter Not Approved Rejection

For All Submitters

What does it mean when a claim file receives an A8:496:85 rejection on a 277CA report with the message "Submitter Not Approved"? EDI Support Services (EDISS) often receives calls related to this rejection and wanted to provide a few of the more common reasons that this rejection occurs and what to check.

Reason What to Check

837 Transaction is not in production

  • Provider should log into their EDISS Connect account to verify that they are in production for the 837 transaction.
  • If sending direct via a Network Service Vendor (NSV), make sure the "I will and/or" option is selected for the 837 transaction. If utilizing a Billing Service or Clearinghouse, make sure that the correct vendor Submitter ID is listed in Connect.

Rendering NPI is being sent as the billing NPI (Professional lines of business only)

  • Verify that the NPI that is being sent in the claim file in loop 2010AA NM109, is the billing NPI.

Note: The rendering NPI would be located in loop 2310B NM109 or the 2420A NM109, if different from what is sent in 2310B NM109.

Tax ID being sent in the file is not on file with the payer

  • Verify that the Tax ID being sent in loop 2010AA REF is valid for the NPI that is being sent in the claim file.

Incorrect Submitter ID is being sent

  • For Medicare JF and Commercial: The GS02 and loop 1000A NM109, need to reflect the Submitter ID associated in Connect with the billing NPI listed in the claim file.
  • For Medicare JE: The ISA06, GS02 and loop 1000A NM109 should all match and contain either the direct Submitter's ID/billing group number or they should all indicate the vendors Submitter ID.

Incorrect payer ID is being sent in the file

  • The payer ID indicated in the ISA08, loop 1000B NM109 and 2010BB NM109 should all match the line of business indicated in Connect. For a list of payer IDs, visit www.edissweb.com and select Contractor IDs under the Quick Links on the Home page.



Message Sent:
February 4, 2020
August 6, 2019
September 4, 2018