Billing for lower limb prosthetic devices presents a unique set of challenges, from navigating ever-changing payer policies to ensuring accurate L-code documentation and meeting tight claim submission deadlines. In fact, studies show that 30-40% of prosthetic claims face delays or denials due to improper coding or documentation errors.
For clinics and prosthetists in North Carolina, partnering with an expert billing service is essential to streamline operations, reduce claim rejections, and accelerate payment cycles.
To help you make an informed decision, we’ve compiled a list of the 15 best lower limb prosthetic billing companies in North Carolina, based on customer reviews, ratings, years of service, and their professional expertise.
While many of these providers offer standard services, Quality Healthcare Systems (QHS) stands out as the most efficient, prosthetist-friendly solution in the state, offering comprehensive support to maximize revenue and minimize payment delays.
What is Prosthetic Billing for Lower Limbs?
Prosthetic billing for lower limbs refers to the specialized process of submitting and managing insurance claims for prosthetic devices used in below-knee (BK), above-knee (AK), and hip disarticulation amputations. It includes coding with HCPCS L-codes, documenting K-level functional abilities, verifying insurance eligibility, and ensuring compliance with Medicare, Medicaid, and private payer guidelines.
This type of billing is complex due to frequent audits, high-cost components, and strict documentation rules. Proper lower limb prosthetic billing ensures faster reimbursements and fewer denials for prosthetists and clinics.
Best Prosthetic Billing for Lower Limbs Companies in North Carolina
| Rank | Company Name | Rating | Specialization | Unique Feature |
|---|---|---|---|---|
| 1 | Quality Healthcare Systems | ⭐⭐⭐⭐⭐ | Lower Limb Prosthetic Billing | Real-time denial tracking, Medicare K-level expertise |
| 2 | Advance Biller | ⭐⭐⭐☆ | Below/Above Knee Prosthetics | Affordable for small NC clinics |
| 3 | Paragon Medical Billing | ⭐⭐⭐☆ | BCBS NC & Medicare Lower Limb Claims | Familiarity with payer-specific guidelines |
| 4 | Physicians Choice Medical Billing | ⭐⭐⭐☆ | Microprocessor Knees & Prosthetic Feet | Consistent coding support |
| 5 | Prosthetic Billing Solutions (PBS) | ⭐⭐⭐☆ | Vacuum suspension and hip disarticulation | Local presence in Durham with basic RCM tools |
| 6 | OrthoBiller | ⭐⭐☆☆ | BK/AK Prosthetic Components | Medicaid credentialing help for new clinics |
| 7 | MedClaims NC | ⭐⭐⭐☆ | High-volume L-code Submissions | Fast claim turnaround with batch support |
| 8 | Billing4Prosthetics | ⭐⭐⭐☆ | Powered Knees and Ankles | Tech-savvy billing for advanced devices |
| 9 | Complete Medical Billing of NC | ⭐⭐☆☆ | Long-term Amputee Billing | Focused on rehab & prosthetic maintenance claims |
| 10 | NC Prosthetic Billing Experts | ⭐⭐⭐☆ | AK/BK Billing & Reauthorizations | Detailed reports for small clinics |
| 11 | Blue Ridge Medical Billing | ⭐⭐☆☆ | Foot-Ankle Prosthetics | Affordable service with limited capacity |
| 12 | Eagle O&P Billing | ⭐⭐⭐☆ | EMR-Integrated Prosthetic Billing | Works with popular O&P EMRs |
| 13 | Carolina Medical Billing Services | ⭐⭐⭐☆ | VA & Medicare Prosthetic Claims | VA-friendly support for limb loss billing |
| 14 | O&P Reimbursement Group | ⭐⭐⭐☆ | K-Level Documentation Consulting | Expert L-code bundling and K-level audits |
| 15 | Outer Banks Billing | ⭐⭐☆☆ | Pediatric & Adult Limb Prosthetics | Boutique billing for coastal NC clinics |
1. QHS Health – Best Lower Limb Prosthetic Billing Company in North Carolina
- Location: North Carolina
- Website: qhshealth.com
- Specialty: Dedicated lower limb prosthetic billing, O&P-specific claim management, Medicare compliance
- Pricing: Plans start from 3% to 7% of collections, based on service level and features included.
- Customer Sentiment: ★★★★★ (Outstanding)
With over 15 years of experience in revenue cycle management, Quality Healthcare Systems (QHS) has established itself as North Carolina’s trusted company for lower limb prosthetic billing services.
QHS develops customized billing workflows tailored specifically for prosthetists and orthotic clinics, ensuring clean claims, fewer denials, and timely reimbursements.
Their focus on accurate documentation, proactive denial management, and audit readiness makes them the go-to billing partner for lower limb prosthetics providers.
By providing scalable and fully managed billing solutions, QHS supports clinics in boosting cash flow and achieving faster payouts—while ensuring full regulatory compliance.
Quality Healthcare Systems – Pros & Cons
| Aspect | Pros | Cons |
|---|---|---|
| Proven Expertise | ✅ 15+ years of experience in lower limb prosthetic billing | |
| Tailored Solutions | ✅ Custom workflows built for prosthetic clinics | ❌ Requires initial setup and clinic input for workflow design |
| Advanced Technology | ✅ Uses intelligent tools for clean claims and denial prevention | |
| Comprehensive Service | ✅ Full-service billing from eligibility verification to appeals | |
| Faster Resolution | ✅ Rapid claim submission and follow-up improve cash flow | |
| Proactive Prevention | ✅ Identifies and addresses billing trends to prevent denials | ❌ Continuous engagement needed to maintain accuracy and updates |
2. Advance Biller
Location: Raleigh, NC
Services: Prosthetic billing for lower extremity devices (AK/BK limbs, prosthetic ankles, knees)
Customer Sentiment: ★★★☆☆ (Average)
Advance Biller is based in Raleigh and serves small to mid-sized O&P clinics across North Carolina. They assist with coding and billing for modular prosthetics, socket components, and prosthetic feet. While their service is consistent, clients mention average response times and a lack of proactive payer follow-ups.
Good for practices seeking affordable help, but not ideal for fast-paced clinics needing aggressive denial management.
| Aspect | Pros | Cons |
|---|---|---|
| Specialized Focus | ✅ Handles billing for AK/BK prosthetics, prosthetic knees, and feet | ❌ Lacks aggressive follow-up for denied claims |
| Affordability | ✅ Cost-effective for small and mid-sized clinics | ❌ Not ideal for fast-paced or high-demand clinics |
| Geographic Access | ✅ Serves clients statewide from Raleigh | ❌ Limited client onboarding support |
| Consistency | ✅ Maintains consistent claim processing | ❌ Average response times reported by clients |
| Client Feedback | ✅ Reasonable pricing praised by clients | ❌ Service lacks personalization or strategic insight |
3. Paragon Medical Billing
Location: Asheville, NC
Services: Lower limb prosthetic billing for Medicare and BCBS NC
Customer Sentiment: ★★★☆☆ (Steady but Slow)
Paragon Medical Billing supports prosthetists by submitting claims for custom-fabricated limbs and add-ons like liners and sleeve interfaces. Based in Asheville, they’ve been praised for their knowledge of BCBS-specific requirements. However, some clients report delays in patient authorizations and manual claim processing.
3. Paragon Medical Billing – Based in Asheville, NC
| Aspect | Pros | Cons |
|---|---|---|
| Payer-Specific Knowledge | ✅ Strong understanding of BCBS NC and Medicare coding | ❌ Manual processes slow down authorizations and claim submissions |
| Local Presence | ✅ Asheville-based with regional support | ❌ Doesn’t support automated reporting or claim status tracking |
| Lower Limb Expertise | ✅ Focuses on liners, sockets, and sleeve interfaces | ❌ Response time for pre-approvals can be delayed |
| Compliance | ✅ Meets payer compliance protocols | ❌ Not ideal for fast pre-auth workflows |
| Client Sentiment | ✅ Reliable but conservative approach appreciated | ❌ May not suit growing or tech-forward clinics |
4. Physicians Choice Medical Billing
Location: Greensboro, NC
Services: Billing for microprocessor knees and prosthetic feet (L5828, L5856, etc.)
Customer Sentiment: ★★★☆☆ (Reliable but Rigid)
Serving practices in Greensboro and surrounding counties, this company helps with billing and documentation for complex lower limb prosthetics. Clients note the company is reliable, but not flexible with customization or smaller-volume practices. Best suited for clinics with steady, repeat procedures.
| Aspect | Pros | Cons |
|---|---|---|
| Prosthetic Focus | ✅ Specializes in billing for L-codes like L5828 (MPK) & L5856 (foot) | ❌ Limited flexibility for custom clinic workflows |
| Reliable Submissions | ✅ Steady support for documentation-heavy submissions | ❌ Not ideal for practices with varied or complex patient cases |
| Regional Knowledge | ✅ Based in Greensboro with multi-county reach | ❌ Rigid systems may not adapt to low-volume clinics |
| Billing Accuracy | ✅ Ensures accuracy in medical necessity letters | ❌ Feedback loop between biller and provider is slow |
| Client Feedback | ✅ Consistent performance | ❌ Lacks innovation or advanced analytics |
5. Prosthetic Billing Solutions (PBS)
Location: Durham, NC
Services: Lower limb prosthetic billing and O&P-focused RCM
Customer Sentiment: ★★★☆☆ (Moderate)
PBS provides support for socket fabrication, hip disarticulation prostheses, and vacuum-assisted suspension systems. While they operate efficiently in Durham and surrounding areas, some clients mention a “basic” service experience without detailed follow-ups or reports unless requested.
| Aspect | Pros | Cons |
|---|---|---|
| End-to-End Billing | ✅ Covers socket fabrication and advanced systems like VASS | ❌ Reports and follow-ups often need to be manually requested |
| O&P Expertise | ✅ Solely focused on orthotics and prosthetics | ❌ Feedback describes a basic, “checklist” billing approach |
| Regional Coverage | ✅ Strong service base in Durham and surrounding clinics | ❌ Lack of real-time claim status dashboards |
| Compliance Handling | ✅ Adheres to payer-specific protocols for lower limb devices | ❌ Not ideal for clinics needing high communication or reporting |
| Customer Sentiment | ✅ Moderate satisfaction from small clinics | ❌ Doesn’t provide strategic billing guidance |
6. OrthoBiller
Location: Wilmington, NC
Services: Prosthetic billing for below-knee and above-knee prosthetics
Customer Sentiment: ★★☆☆☆ (Basic)
Located in Wilmington, OrthoBiller helps new prosthetists with Medicaid credentialing and submission of standard L-codes. They provide standard billing templates but lack advanced tools like denial dashboards or real-time claim updates. Clinics looking for proactive support might find them limited.
| Aspect | Pros | Cons |
|---|---|---|
| Medicaid Support | ✅ Helps new prosthetists with credentialing | ❌ Very limited tools for tracking denials or aged claims |
| Local Clinics | ✅ Wilmington-based with outreach to rural areas | ❌ Doesn’t scale well with growing or multi-location practices |
| Affordable Templates | ✅ Provides basic billing templates for common L-codes | ❌ Lacks advanced billing tools and automation |
| Entry-Level Support | ✅ Suits beginners in the prosthetic billing space | ❌ Not recommended for clinics needing fast or error-free workflows |
| Customer Sentiment | ✅ Appreciated by startups | ❌ Scored low for proactive service and communication |
7. MedClaims NC
Location: Chapel Hill, NC
Services: High-volume lower limb prosthetic claims processing
Customer Sentiment: ★★★☆☆ (Average with Fast Turnaround)
MedClaims NC is known for its speed in filing claims, especially for socket replacements and dynamic-response feet. Based in Chapel Hill, their software support is appreciated, but the customer service has been described as “transactional” and not tailored for individual clinic needs.
| Aspect | Pros | Cons |
|---|---|---|
| High-Volume Capacity | ✅ Efficient at submitting frequent lower limb prosthetic claims | ❌ Described as “transactional” with limited customization |
| Turnaround Speed | ✅ Quick processing for codes like L5647 (socket) and L5987 (foot) | ❌ Doesn’t offer a personalized account manager |
| Technology Stack | ✅ Robust claim software for batch submissions | ❌ Little transparency in denial follow-up processes |
| Regional Access | ✅ Serves both urban and rural NC clinics | ❌ Not suitable for clinics needing frequent claim communication |
| Client Sentiment | ✅ Known for speed | ❌ Feedback notes lack of individualized care or strategy |
8. Billing4Prosthetics
Location: Fayetteville, NC
Services: Authorization support and coding for prosthetic knees and ankles
Customer Sentiment: ★★★☆☆ (Tech-Savvy but Limited Follow-Up)
Fayetteville-based Billing4Prosthetics is popular among clinics needing help with newer prosthetic tech like powered knees. They are good with HCPCS accuracy but clients report that follow-up on rejections and appeals is slower than expected.
| Aspect | Pros |
|---|---|
| Tech-Savvy Support | ✅ Good with newer prosthetic technologies like powered knees |
| HCPCS Coding Accuracy | ✅ Known for precise HCPCS coding and billing accuracy |
| Authorization Support | ✅ Provides solid authorization support for prosthetic claims |
| Aspect | Cons |
|---|---|
| Slow Follow-Up | ❌ Follow-ups on rejections and appeals can be delayed |
| Limited Denial Management | ❌ Lacks proactive denial management strategies |
| Minimal Client Engagement | ❌ Clients report that the service is somewhat hands-off |
| Reactive Approach | ❌ Primarily reacts to issues rather than preventing them |
| Infrequent Updates | ❌ Clients don’t receive frequent status updates on claims |
9. Complete Medical Billing of NC
Location: High Point, NC
Services: Prosthetic billing for limb rehabilitation and post-amputation care
Customer Sentiment: ★★☆☆☆ (Minimal Involvement)
Complete Medical Billing handles billing for clinics treating long-term amputees. Though they are active in High Point and central NC, customers feel the team is “hands-off” and mainly handles basic claims, without much consultation or denial advocacy.
| Aspect | Pros |
|---|---|
| Limb Rehabilitation Billing | ✅ Handles billing for complex limb rehabilitation cases |
| Post-Amputation Care Support | ✅ Works well with clinics treating long-term amputee patients |
| Affordable | ✅ Known for cost-effective services for basic billing needs |
| Aspect | Cons |
|---|---|
| Minimal Client Involvement | ❌ Very hands-off approach, with limited interaction and advice |
| Lack of Denial Advocacy | ❌ Does not proactively manage denials or payer rejections |
| Basic Claims Processing | ❌ Primarily focuses on basic claim submissions |
| Slow Follow-Up | ❌ Clients report delays in receiving follow-ups |
| No Consultation | ❌ Little to no consultation offered for complicated cases |
10. NC Prosthetic Billing Experts
Location: Hickory, NC
Services: AK/BK prosthetic billing, reauthorizations, claim analytics
Customer Sentiment: ★★★☆☆ (Helpful, but Limited Scope)
Operating in Hickory, they work with clinics offering transfemoral and transtibial solutions. Clients like their easy-to-understand reports but wish for deeper involvement in medical documentation and payer appeals.
| Aspect | Pros |
|---|---|
| Easy-to-Understand Reports | ✅ Clients appreciate clear and easy-to-understand billing reports |
| Proactive Reauthorizations | ✅ Works efficiently on reauthorizations for prosthetic claims |
| Claim Analytics | ✅ Provides basic analytics to help track claim progress |
| Aspect | Cons |
|---|---|
| Limited Scope | ❌ Focus is mostly on AK/BK claims, with limited specialization |
| Basic Documentation Support | ❌ Limited assistance with complex medical documentation |
| Lacks Denial Support | ❌ Does not provide extensive support for payer appeals |
| Limited Customization | ❌ No custom billing workflows tailored to individual clients |
| Not High-Tech | ❌ Lacks advanced tools for claim tracking and real-time updates |
11. Blue Ridge Medical Billing
Location: Boone, NC
Services: DME billing for prosthetic feet and ankle devices
Customer Sentiment: ★★☆☆☆ (Understaffed)
This Boone-based service handles Medicare billing for foot-ankle prosthetics. While affordable, multiple clients mention staff turnover and long wait times for basic claim updates or portal access.
| Aspect | Pros |
|---|---|
| Affordable | ✅ Known for offering cost-effective billing solutions |
| Medicare Billing Expertise | ✅ Proficient in handling Medicare billing for foot/ankle devices |
| Simplicity | ✅ Simple, no-frills billing process for standard cases |
| Aspect | Cons |
|---|---|
| Understaffed | ❌ Staff turnover results in delays and limited availability |
| Slow Response Times | ❌ Long wait times for claim updates and portal access |
| Minimal Technology | ❌ Does not have advanced tech for claim tracking or reporting |
| Limited Scope | ❌ Primarily focused on foot/ankle prosthetics, not full services |
| Reactive Customer Service | ❌ Fewer proactive updates and client follow-ups |
12. Eagle O&P Billing
Location: Winston-Salem, NC
Services: EMR-integrated billing for prosthetic providers
Customer Sentiment: ★★★☆☆ (Systematic but Impersonal)
Eagle is consistent in billing for components like socket locks and flex-walk feet. Based in Winston-Salem, they’re often chosen by clinics using standard EMRs, but users note the experience can feel “corporate” with limited hands-on support.
| Aspect | Pros |
|---|---|
| EMR Integration | ✅ Works seamlessly with standard EMR systems for ease of use |
| Systematic Approach | ✅ Consistent and reliable billing workflows |
| Broad Range of Services | ✅ Offers billing support for a variety of prosthetic components |
| Aspect | Cons |
|---|---|
| Impersonal Experience | ❌ Clients report a corporate, impersonal approach to service |
| Limited Hands-On Support | ❌ Lacks personalized support and guidance |
| Basic Reporting | ❌ Offers standard reporting, with no advanced analytics |
| No Denial Prevention Tools | ❌ Doesn’t provide proactive claim denial management |
| Not Highly Customizable | ❌ Billing processes are standardized, with no custom workflows |
13. Carolina Medical Billing Services
Location: Cary, NC
Services: Veteran Affairs and Medicare billing for prosthetic limbs
Customer Sentiment: ★★★☆☆ (Decent, VA-Focused)
Cary-based Carolina MBS supports claims for VA patients and Medicare prosthetic fittings. Clinics find them acceptable for repetitive cases, though some say they aren’t ideal for newer prosthetic technologies or K3+ level amputees.
| Aspect | Pros |
|---|---|
| VA Billing Expertise | ✅ Specialized in VA billing for prosthetic limbs |
| Medicare Experience | ✅ Strong knowledge of Medicare billing requirements |
| Stable and Reliable | ✅ Provides consistent billing services for veterans |
| Aspect | Cons |
|---|---|
| Limited to VA and Medicare | ❌ Doesn’t cater well to private payers or advanced technologies |
| Basic Technology | ❌ Lacks modern claim tracking and denial management tools |
| Not Ideal for Complex Cases | ❌ Not equipped to handle complex or non-standard prosthetic cases |
| Slow to Adapt | ❌ Doesn’t handle newer prosthetic tech well |
| No Customization | ❌ Offers one-size-fits-all service for all clients |
14. O&P Reimbursement Group
Location: Greenville, NC
Services: Consulting and billing for functional level documentation
Customer Sentiment: ★★★☆☆ (Good for Consulting)
This company advises on K-level documentation and L-code bundling. Clinics in Greenville and surrounding areas rely on them for guidance, but most still need an in-house biller or second service for full RCM.
| Aspect | Pros |
|---|---|
| Expert Consulting | ✅ Known for expert guidance on functional level documentation |
| L-Code Bundling | ✅ Helps clinics bundle L-codes for accurate billing |
| Reimbursement Knowledge | ✅ Provides in-depth advice on reimbursement practices |
| Aspect | Cons |
|---|---|
| Limited RCM Support | ❌ Doesn’t provide full Revenue Cycle Management (RCM) services |
| Needs In-House Support | ❌ Clients still need an internal biller for complete support |
| No Real-Time Claim Tracking | ❌ Lacks tools for real-time claim tracking and denial alerts |
| Not Hands-On | ❌ Primarily offers consulting, with limited ongoing support |
| No Billing Automation | ❌ Doesn’t utilize automation for claims or reports |
15. Outer Banks Billing
Location: Kill Devil Hills, NC
Services: Boutique billing for pediatric and adult limb prosthetics
Customer Sentiment: ★★☆☆☆ (Personalized, but Small Scale)
Outer Banks Billing supports lower limb prosthetic practices in coastal NC, especially for pediatric patients. Clinics appreciate their personal approach, but also cite slow turnarounds and limited technology adoption.
| Aspect | Pros |
|---|---|
| Personalized Service | ✅ Provides personalized billing services tailored to each client |
| Pediatric Prosthetic Expertise | ✅ Specializes in pediatric prosthetics |
| Small Clinic Support | ✅ Ideal for smaller clinics needing personalized care |
| Aspect | Cons |
|---|---|
| Slow Turnaround | ❌ Long processing times for claims |
| Limited Technology | ❌ Lack of advanced billing and claim tracking tools |
| Small Scale | ❌ Limited capacity for large-volume billing |
| Basic Billing Systems | ❌ Uses manual systems instead of modern automated processes |
| Reactive Approach | ❌ Service tends to be reactive, not proactive in addressing issues |
Why Do Lower Limb Prosthetists in North Carolina Trust QHS for Prosthetic Billing Services?
Quality Healthcare Systems (QHS) is the leading medical billing service provider for lower limb prosthetists in North Carolina. With extensive experience in managing the complexities of prosthetic billing—including L-code documentation, prior authorizations, and coordination with insurance providers—QHS offers unparalleled accuracy, efficiency, and reimbursement success.
Whether you’re billing for above-knee (AK) or below-knee (BK) prosthetics, socket components, or specialized prosthetic feet, QHS ensures timely claim submissions, swift denial resolution, and strict compliance with payer-specific policies. Their expertise helps prosthetists focus on patient care while optimizing cash flow and reducing billing challenges.
Transparent, Scalable Pricing
QHS offers flexible pricing models that scale with your practice’s needs—whether you’re a solo orthodontist or a multi-location clinic. Our plans are designed to offer maximum value with complete transparency:
- Lite Plan – 3%: Covers claim reviews, submissions, denial follow-ups, and post-payment tasks.
- Premium Plan – 5%: Includes everything in the Lite Plan plus custom billing reports and software access.
- Premium+ Plan – 7%: Adds patient invoicing, audit support, and additional user access for larger teams.
Real Results in 30–90 Days
Orthodontic practices working with QHS see measurable improvements in collections, claim turnaround time, and denial resolution within the first 30 to 90 days. Our tailored approach to braces and orthodontic billing ensures your revenue cycle is optimized from day one.
Frequently Asked Questions
Why Is Choosing the Right Prosthetic Billing Company Important?
Choosing the right prosthetic billing company is crucial to avoid claim denials, delays, and underpayments. An experienced billing partner ensures accurate coding, timely claim submissions, and proactive denial management, ultimately optimizing cash flow for prosthetists and clinics.
What Are the Top Prosthetic Billing Services in North Carolina?
Some of the best prosthetic billing services in North Carolina include Quality Healthcare Systems (QHS), Advance Biller, Paragon Medical Billing, and Physicians Choice Medical Billing. These companies specialize in lower limb prosthetics, offering reliable services with a focus on accurate coding, compliance, and fast reimbursements.
How Do Billing Companies Handle Prosthetic Device Documentation?
Billing companies handle lower limb prosthetic documentation by managing L-code assignments, verifying patient eligibility, submitting claims, and coordinating with insurers for pre-authorizations. They ensure all documentation is compliant with payer-specific requirements to minimize claim rejections.
What Are the Common Challenges in Lower Limb Prosthetic Billing?
Common challenges in lower limb prosthetic billing include incorrect coding, lack of pre-authorization, delayed payments, and claim denials. These issues can lead to financial strain on prosthetic practices. Experienced billing companies help resolve these challenges through proper documentation, follow-ups, and denial management strategies.
How Can a Prosthetic Billing Company Help with Denial Management?
A prosthetic billing company helps with denial management by identifying the causes of denials, submitting necessary appeals, and reprocessing claims. They work proactively to resolve issues, ensuring that claims are paid correctly and quickly, ultimately improving the financial health of prosthetic practices.
