By the way, you didn't disclosed your configuration, so nobody know what you overlooked. All I can claim is - it works for me.
At the first, you need to decide the device is making call to upstream provider, but it is rejected, or there is no attempt to call. Catch SIP packet between SPA232D and upstream Telco. Turn on syslog&debug on SPA232D and catch them. It will help you (or us) to analyze the issue.