Going Paperless & Gaining Productivity

How United Support Services Streamlined Recordkeeping, HR & Billing To Save Hours Every Month With SETWorks

Two women sitting at a table talking with a laptop in front of them.

About United Support Services (USS)

United Support Services (USS) was founded in 2002 by a family who was seeking an agency that put individuals with disabilities first. Today, USS provides family-centered services for over 175 individuals with developmental disabilities  throughout the state of North Carolina. USS is a CQL Accredited Agency and an Innovations Waiver Medicaid Service Provider.

Participants: 175 individuals

North Carolina

Location: North Carolina

Victoria Garland Headshot On Blue Element background

“SETWorks helped simplify everything we need into one program, so we don’t have to run multiple platforms to achieve what we need to do.”

Victoria Garland //  Director //  United Support Services


Paper-based processes killing productivity

United Support Services (USS) empowers North Carolina families to navigate the state’s Medicaid waiver system so they can receive the best possible services. But behind the scenes — and invisible to those families — the agency’s recordkeeping, HR, and billing processes were painfully complex.


USS’ team of 250+ employees were spread out across the state, with some even three hours away from the office. Staff would complete their documentation on paper and scan, mail, or fax the forms back to the office. Then it was up to a small team of administrative staff to manually key each sheet, line by line, page by page, into seven different managed care organizations’ (MCO) databases for billing.


This created a number of problems and inefficiencies. For one, staff didn’t have access to current information when they were out in the field.

"For them, it took a lot more work to come and have a physical record that they can get information from," said USS Director Victoria Garland. "Then there's the cost of paper, printing, and mail."

Back at the office, it took three full time support staff and two HR people just to keep up with the administrative workload. Staff wasted hours every month from gathering and keying data. And with no easy way to track to-do’s and due dates, it was all too easy for critical tasks like supervisions to get overlooked — which ultimately resulted in paybacks.

“We’ve had times in the past where our qualified professionals (QPs) would check off that something was done, but it hadn’t been or we couldn’t find it,” says Victoria.

Seeing the need for a more efficient solution, USS began a search for a new platform that would help them digitize their processes. After reviewing three other options, USS chose SETWorks because it was the most user-friendly solution and because it was geared specifically toward the IDD industry.

“You can tell that SETWorks was designed and developed by people who are working directly with the disability service space. It’s geared toward the IDD population whereas so many other programs are only geared toward mental health or medical,” explains Victoria


A unified electronic platform with instant access to information

By the time Assistant Director Donna Roberts signed on in February 2018, USS had already begun setting up SETWorks. Having used other systems in the past, she was immediately impressed with how adaptable SETWorks was to the needs of their agency.


Even better was the hands-on support they received from SETWorks Client Operations Director Preston Finkle and the rest of the team.


“There’s so much ability to individualize SETWorks,” says Donna. “Having Preston there to show us what was available and help us make decisions and not leave us out on our own was so helpful.”


SETWorks brought USS’ client data, staff records, and billing into a single platform and empowered them to manage the entire picture of service delivery with ease.

“SETWorks is like a three-in-one program: you get your data from the direct care staff, you get your tracking of employment (trainings and dates and information), and then you’ve got your billing directly coming from your data,” says Donna.

One of the most exciting developments was the ability to set up electronic forms. Instead of paper forms, USS now generates common forms such as quarterly outcomes, auto-populates them with data that’s already in the system, and even collects signatures electronically.

A USS participant smiles with the pumpkin they are painting

“I’ve never used a program that has forms function the way they do in SETWorks,” says Donna. “Just being able to duplicate forms so that you’re not wasting your time filling out the same information, the way the signatures work, the individualization of the forms, the if-thens, the way that it’s able to pull in other information — it’s brilliant!”

USS also set up tasks in SETWorks to manage all of their critical to-do’s and focus on what needs to get done.

“At the end of a quarter, our QPs could have something like 90 tasks that they have to get done,” explains Donna. “Now, they can work on them throughout the quarter and have a running tally in SETWorks of what’s still left. They really like to be able to see that and help plan their time out.”

SETWorks even worked with USS to streamline and automate its manual billing processes — a “godsend” for an agency with multiple funders.

“We submit billing to seven different MCOs, which was a pain to do manually. But SETWorks was able to set up individualized files for us to be able to bill each MCO, which saves a great amount of time,” says Victoria.

But it was SETWorks’ EVV capability that proved to be an unexpected lifesaver. Not only did SETWorks provide USS with the tools needed to be in compliance, they were also able to share their expertise on EVV since they had been involved in the process in other states.

“SETWorks saved us with EVV,” says Victoria. “They came to us and said, are you guys engaged in planning for this? And we’re like, what are you talking about? So SETWorks was ahead of the game, and got us really asking the questions and looking into it to be prepared — much more so than even our MCOs were.”


Saving time, eliminating manual data entry, and decreasing costs

SETWorks has been a huge timesaver for the USS team. Gathering, validating, and submitting billing data now takes a fraction of the time that it used to.

"The fact that we're able to batch the data the way we need to and split things out, review it, and send it is so great and super clean," says Victoria.

Because SETWorks eliminates manual data entry, it completely removed the “mistake factor” for USS.

“Before SETWorks, when we did a post-payment review, we had issues like, did the goals on the data sheets match the signed goals in the file word-for-word? Were there changes to the goals that did not get reflected in the data sheets? There could be any manual data errors that could be present,” says Donna. “Now, billing matches documentation perfectly.”

SETWorks empowers its clients by providing everything they need through one platform.

And, because of the limits configured in the system, USS doesn’t have to worry about denials for over units.

 “We are able to catch any issues as they are happening and not after the fact, said Donna.

With SETWorks, Victoria says that going into audits is a whole new ballgame.

“We have an audit here right now and I’m like, no big deal! Because everything is there. It’s clean. It’s organized. It’s easy to access. It looks professional when you extract it out of the system. It’s just great.” 

That’s not all that SETWorks has changed for USS.

“We’re actually working with one of our MCOs right now to eliminate some of the attestations that we have to complete each quarter, simply because we have an EHR that meets that requirement on every member. They’re looking into it, and if they agree, we’ll be able to sign off once and never do it again" says Victoria.

With so many efficiency gains, SETWorks has freed up their staff to focus on other things. This makes USS more competitive — and adds value for the families they serve.


“We don’t key anything in anymore, which is a significant change,” says Donna. “For example, our administrative specialist Kristyn was mainly keying billing into the MCOs. Now she helps reach out to staff to organize our trainings, ensure they don’t have lapses in HR-related documents, and track RA billing rejections.  She went from doing mainly one task to taking on three completely new tasks instead.”


Eliminating paper records has also resulted in significant cost savings for USS, both in terms of paper records and personnel.


“You’ve got the increased cost of an EHR, but then you have the decreased cost of paper and mail, and the decreased cost of staff,” explains Donna. “We used to need to have three support staff, we have one now. We used to need to have two HR people, we have one now.”

Participants in the Durham, NC Disability Pride Parade

Her team loves SETWorks as well. Staff in the field have current and up-to-date access to everything they need to work with USS’ members. Plus, they can see their schedules, put in their notes, and clock in and out for EVV — all from a smartphone.


“We’ve been really happy when we go to hire people and they state that they’ve already used SETWorks,” says Donna. “They’ve always indicated that they preferred SETWorks over other systems that they’ve used.”


USS says they recommend SETWorks to any provider looking to save their team time and make them more efficient at service delivery.


“SETWorks has made us better and helped us stand out. The fact that they are working with multiple states and staying on top of what every state has coming up, including ours, has just been amazing.”

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