SETWorks eBilling Compatibility

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 2025.

Compatible Funding Sources

SETWorks is currently integrated with the following funding sources:

StateFunderSubmission ProcessRemittance Advice Available
ArkansasArkansas MedicaidElectronicYes
ArkansasSummit Community CareElectronicYes
ArkansasCaresourceElectronicYes
ArkansasEmpower SolutionsElectronicYes
ArkansasArkansas Total CareElectronicYes
ColoradoColorado MedicaidElectronicYes
GeorgiaGeorgia Health Partnership (Georgia Medicaid)ElectronicYes
IowaWellpoint (formerly Amerigroup)ElectronicYes
IowaIowa Total CareElectronicYes
Iowa
Iowa Medicaid Enterprises (IME)
Manual
Yes
Iowa
Molina
Electronic
Yes
Iowa
(PENDING) Champ VA
Electronic
Pending
Iowa
(PENDING) Surest
Electronic

Pending

Iowa
(PENDING) Blue Cross Blue Shield (Wellmark)
Electronic

Pending

Iowa
(PENDING) United Health Care (UHC)
Electronic

Pending

KansasAetna Better Health KansasElectronicYes
KansasUnited Health Care (UHC)ElectronicYes
Kansas
Healthy Blue Kansas
Electronic
Yes
KansasSunflower Health PlanElectronicYes
KentuckyKentucky MedicaidElectronicYes
MichiganMORCElectronicNo
MichiganODINManualNo
Michigan
The Arc of Oakland County
Manual
No
MichiganIntegrated Services of KalamazooManualYes
MinnesotaMN-ITS (Minnesota Medicaid)ElectronicYes
MissouriCIMORElectronicYes
MissouriMOHealthNetElectronicYes
New JerseyNew Jersey MedicaidManualNo
North CarolinaSandhillsElectronicYes
North CarolinaAlliance HealthElectronicYes
North CarolinaEastpointeElectronicYes
North CarolinaTrillium Health ResourcesElectronicYes
North CarolinaPartners Behavioral HealthElectronicYes
North CarolinaVaya HealthElectronicYes
Ohio
Ohio Medicaid
Electronic
Pending
OregoneXPRSManualNo
Pennsylvania
Magellan
Electronic
 Yes
PennsylvaniaPROMISeElectronicYes
South Dakota
 South Dakota Medicaid
Electronic
Yes
Virginia
Medicaid
Electronic
Yes
WashingtonAmerigroupElectronicYes
WisconsinMy Choice WisconsinElectronicYes
WisconsinInclusa WPSElectronicYes

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.

    • Related Articles

    • SETWorks AI - Agent Builder

      How do I build my own AI agent? SETWorks offers the ability to build your own AI agent, which is stored personally and can be continuously referable for future use. Access AI Agent Builder 1. Access SETWorks AI at the top of the screen. 2. Select ...

    • SETWorks AI Assistant for the Advanced Report Builder

      SETWorks AI Assistant for the Advanced Report Builder The SETWorks Advanced Report Builder (beta) includes a SETWorks AI-powered assistant designed to simplify your reporting experience. This article will guide you on how to effectively use the AI ...

    • About EVV & eBilling In Missouri

      How do I submit activity records to Sandata and electronically to CIMOR? Administrators Missouri Clients Only - This article is written with Missouri's organizations and rules in mind.  Terminology can be modified within SETWorks to better fit the ...

    • SETWorks Webinar - March 2025 - Electronic Billing

      Recording On March 19th, 2025, SETWorks hosted a live webinar about Electronic Billing in SETWorks. You can view the recording from the link below: https://youtu.be/eJm9pTtq2dQ Compatibility - Supported Funders Check to see if your funders support ...

    • Creating Your First Report in the Advanced Report Builder

      Creating Your First Report in the Advanced Report Builder Watch the video: Creating your first report - watch the video Step-by-step instructions: To open the Advanced Report Builder, click on Settings, then Provider Build, and then the "Advanced ...