Resolution: The problem was we had a System Account but our application was
NOT a System Application. To create a System application in
https://code.cerner.com/developer/smart-on-fhir/apps you will need to insert your System Account ID into the GUID field.
What if you already have a patient or provider application, can I just convert this to a System application? The answer is no. Once you register an app, the app is immediately registered and has a client ID. In this situation you will have to create a new system application.
When you register the System App and provide the System Account ID (GUID) the GUID becomes your System App's clientID and a connection is established between your System App & System Account.