Claim edit: Invalid submitter ID
Stedi now rejects 837P professional, 837D dental, and 837I institutional claims when the submitter ID doesn't match the payer's required format.
How the edit works
In a claim, the submitter ID tells the payer who submitted the claim.
This submitter isn't necessarily the provider who rendered care or is being paid for the claim. It could be a billing service or other vendor acting on the provider's behalf.
| Claim type | JSON API field | X12 segment |
|---|---|---|
| 837P professional | submitter.submitterIdentification | NM109 (Submitter Identification Number) of Loop 1000A (Submitter Name) |
| 837D dental | submitter.submitterIdentification | NM109 (Submitter Identification Number) of Loop 1000A (Submitter Name) |
| 837I institutional | submitter.taxId | NM109 (Submitter Identification Number) of Loop 1000A (Submitter Name) |
Payer-assigned submitter IDs
Most payers accept standard submitter IDs, such as an Employer Identification Number (EIN) or other Tax Identification Number (TIN).
Some payers, including some Medicare Administrative Contractors (MACs) and state Medicaid programs, require submitters to use a specific payer-assigned submitter ID instead.
Payer-assigned submitter IDs are issued during transaction enrollment and tend to follow payer-specific formats. For example, a required prefix followed by a fixed number of digits.
If you submit a claim to one of these payers and don’t use a payer-assigned submitter ID, the payer may reject the claim. This can delay payment for the provider.
This edit – the industry term for an automated validation rule – catches the issue before the claim reaches the payer.
Rejection errors
If you submit a claim using Stedi's Claim Submission API endpoints and the claim fails the edit, you'll get back an error response in real time. The response includes details in the errors array.
The exact error message varies by payer and includes guidance on how to fix the submitter ID. For example:
{
"errors": [
{
"code": "33",
"description": "Invalid Submitter Identifier. This payer requires a specific-assigned identifier that begins with AZ followed by 5 or 6 numbers. The submitted value 921545753 does not follow this format and must be confirmed with the payer. Correct and resubmit.",
"followupAction": "Please Correct and Resubmit"
}
]
}If you submit a claim using SFTP and the claim fails the edit, Stedi will reject the claim with a 277CA claim acknowledgment. The acknowledgment will include a related claim status category code, claim status code, and error message:
STC*A7>478*[DATE]*U*[AMOUNT]******A7>733>41**Invalid Submitter Identifier. This payer requires a specific-assigned identifier that begins with AZ followed by 5 or 6 numbers. The submitted value 921545753 does not follow this format and must be confirmed with the payer. Correct and resubmit.~