SETWorks eBilling Compatibility
What Funding Sources are Compatible with SETWorks eBilling?
Billing, Administrators
SETWorks is able to send requests for reimbursement to many different funders electronically. Please consult the table below to learn which funders are supported. Updated 12/2025.
Compatible Funding Sources
SETWorks is currently integrated with the following funding sources:
| State | Funder | Submission Process | Remittance Advice Available |
| Arkansas | Arkansas Medicaid | Electronic | Yes |
| Arkansas | Summit Community Care | Electronic | Yes |
| Arkansas | Caresource | Electronic | Yes |
| Arkansas | Empower Solutions | Electronic | Yes |
| Arkansas | Arkansas Total Care | Electronic | Yes |
| Colorado | Colorado Medicaid | Electronic | Yes |
| Georgia | Georgia Health Partnership (Georgia Medicaid) | Electronic | Yes |
| Iowa | Wellpoint (formerly Amerigroup) | Electronic | Yes |
| Iowa | Iowa Total Care | Electronic | Yes |
Iowa | Iowa Medicaid Enterprises (IME) | Electronic | Yes |
Iowa | Molina | Electronic | Yes |
Iowa | Champ VA | Electronic | Yes |
Iowa | |
|
|
Iowa | Blue Cross Blue Shield (Wellmark) |
|
|
Iowa
| Safety Net Information Management System (SNMIS) | Manual | No |
Iowa | |
|
|
| Kansas | Aetna Better Health Kansas | Electronic | Yes |
| Kansas | United Health Care (UHC) | Electronic | Yes |
Kansas | Healthy Blue Kansas | Electronic | Yes |
| Kansas | Sunflower Health Plan | Electronic | Yes |
| Kentucky | Kentucky Medicaid | Electronic | Yes |
| Michigan | MORC | Electronic | No |
| Michigan | ODIN | Manual | No |
Michigan | The Arc of Oakland County | Manual | No |
| Michigan | Integrated Services of Kalamazoo | Manual | Yes |
| Minnesota | MN-ITS (Minnesota Medicaid) | Electronic | Yes |
| Missouri | CIMOR | Electronic | Yes |
| Missouri | MOHealthNet | Electronic | Yes |
| New Jersey | New Jersey Medicaid | Manual | No |
| North Carolina | Alliance Health | Electronic | Yes |
| North Carolina | Eastpointe | Electronic | Yes |
| North Carolina | Trillium Health Resources | Electronic | Yes |
| North Carolina | Partners Behavioral Health | Electronic | Yes |
| North Carolina | Vaya Health | Electronic | Yes |
| Oregon | eXPRS | Manual | No |
| Pennsylvania | Magellan | Electronic | Yes |
Pennsylvania | County Billing | Electronic | No |
| Pennsylvania | PROMISe | Electronic | Yes |
South Dakota | South Dakota Medicaid | Electronic | Yes |
Virginia | Medicaid | Electronic | Yes |
Washington | ProviderOne | Manual | No |
| Washington | Amerigroup | Electronic | Yes |
| Wisconsin | My Choice Wisconsin | Electronic | Yes |
| Wisconsin | Inclusa WPS | Electronic | Yes |
Wisconson | ForwardHealth | Manual | Yes |
Please speak with your Onboarding Manager or Client Success to learn more if you're interested or if you don't see your funding sources on this list.
What does Electronic vs Manual mean?
For all of the above funders, SETWorks has invested time in understanding billing requirements. Submission processes vary by funder but can include:
- Electronic: This funder supports batch billing via an electronic connection. SETWorks will generate the billing file according to the funder's specifications and submit it on behalf of the provider through that electronic connection.
- Manual: This funder supports batch billing (billing multiple claims in a single file) but does not have an electronic connection available. SETWorks will generate the file according to the funder's specifications and the provider can download that file from SETWorks and then upload it into the funder's provider portal.
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