Billing for hemipelvectomy prosthetics is complex. Documentation must be precise, coding must align with medical necessity, and payer rules leave no room for error. Even experienced providers face high denial rates—often over 30%, especially for major limb prosthetics.
If you operate a prosthetic clinic in North Carolina, you know the risk: delayed payments, increased rework, and interrupted patient care. The right billing partner can prevent that.
Below is a list of 15 prosthetic billing companies in North Carolina that understand the specifics of hemipelvectomy claims. These firms were selected for their:
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Experience with O&P billing
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Accuracy with L-codes and modifiers
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Knowledge of Medicare and private payer policies
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Proven results reducing denials and AR times
Quality Healthcare Systems (QHS) is a standout. Known for fast response times and deep prosthetic billing knowledge, QHS helps providers submit clean claims, follow payer guidelines, and get reimbursed on time.
What is Hemipelvectomy Prosthetic Billing?
Hemipelvectomy prosthetic billing is the process of coding, documenting, and submitting insurance claims for prosthetic limbs used after a hemipelvectomy surgery. It requires accurate HCPCS coding, proof of medical necessity, K-level documentation, and compliance with Medicare and private payer rules to ensure timely reimbursement and prevent denials.
Best Hemipelvectomy Prosthetic Billing Services in North Carolina
| Rank | Company Name | Rating | Specialization | Unique Feature |
|---|---|---|---|---|
| 1 | Quality Healthcare Systems | ⭐⭐⭐⭐⭐ | Hemipelvectomy Prosthetic Billing ✅ | Real-time claim tracking, K-level documentation, and Medicare audit support |
| 2 | Advance Biller | ⭐⭐⭐☆ | Major Limb Prosthetic Billing | Affordable packages for small NC prosthetic clinics |
| 3 | Paragon Medical Billing | ⭐⭐⭐☆ | Medicare & BCBS Prosthetic Claims | Expertise in payer-specific coding for hemipelvectomy prostheses |
| 4 | Physicians Choice Medical Billing | ⭐⭐⭐☆ | Complex Lower-Limb Prosthetic Cases | In-depth support for socket and alignment billing in hemipelvectomy cases |
| 5 | Prosthetic Billing Solutions (PBS) | ⭐⭐⭐☆ | High-Complexity Amputation Billing | Local presence in Durham with custom workflows for hemipelvectomy patients |
| 6 | OrthoBiller | ⭐⭐☆☆ | Medicaid Prosthetic Claims | Assistance with Medicaid enrollment and hemipelvectomy-specific documentation |
| 7 | MedClaims NC | ⭐⭐⭐☆ | High-Volume K-Level Submissions | Efficient batch processing and modifier use for major limb loss prosthetics |
| 8 | Billing4Prosthetics | ⭐⭐⭐☆ | Custom Prosthetic Device Billing | Tech-enabled workflows for tracking multi-component hemipelvectomy claims |
| 9 | Complete Medical Billing of NC | ⭐⭐☆☆ | Post-Op & Long-Term Prosthetic Billing | Support for long-term rehab claims and ongoing prosthetic adjustments |
| 10 | NC Prosthetic Billing Experts | ⭐⭐⭐☆ | Prosthetic Documentation Review | Tailored feedback for hemipelvectomy claims to improve first-pass approval rate |
| 11 | Blue Ridge Medical Billing | ⭐⭐☆☆ | Entry-Level Prosthetic Billing Services | Basic services for new prosthetic providers with limited coding knowledge |
| 12 | Eagle O&P Billing | ⭐⭐⭐☆ | EMR-Integrated Prosthetic Billing | Compatible with EMRs used by O&P clinics handling hemipelvectomy cases |
| 13 | Carolina Medical Billing Services | ⭐⭐⭐☆ | VA & Medicare Hemipelvectomy Claims | Billing support for veterans with major limb amputations |
| 14 | O&P Reimbursement Group | ⭐⭐⭐☆ | L-Code Bundling & K-Level Strategy | Focused on audit prep and L-code optimization for hemipelvectomy devices |
| 15 | Outer Banks Billing | ⭐⭐☆☆ | Niche Amputation Billing Services | Boutique billing firm for coastal providers managing high-amputation cases |
1. QHS Health – Best Hemipelvectomy Prosthetic Billing Company in North Carolina
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Location: North Carolina
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Website: qhshealth.com
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Specialty: Hemipelvectomy prosthetic billing, custom limb prosthesis claims, K-level documentation, Medicare compliance
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Pricing: Starts at 3%–7% of collections (volume-based)
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Customer Sentiment: ★★★★★ (Outstanding)
QHS Health is the top-rated billing company for hemipelvectomy prosthetics in North Carolina. With over 15 years of experience in prosthetic billing, QHS is trusted by clinics managing complex limb loss cases that require accurate coding, custom modifiers, and flawless documentation.
They specialize in managing hemipelvectomy billing with a compliance-first approach—ensuring every HCPCS code is backed by K-level assessments, functional justification, and payer-specific templates. From patient eligibility and prior auths to appeals and audit prep, QHS handles the entire billing cycle so practices can focus on care.
What sets QHS apart is its responsive support, real-time denial tracking, and smart tools built to improve clean claim rates for high-dollar prosthetic devices. Clinics see faster payments, fewer write-offs, and better long-term cash flow.
Pros & Cons of QHS for Hemipelvectomy Prosthetic Billing
| Aspect | Pros | Cons |
|---|---|---|
| Proven Expertise | ✅ 15+ years in high-complexity prosthetic billing, including limb loss cases | |
| Tailored Solutions | ✅ Custom-built workflows for hemipelvectomy and lower-limb prosthetic clinics | ❌ Requires initial documentation setup from the clinic |
| Audit-Ready Support | ✅ Deep Medicare experience to meet all compliance and prepayment review needs | |
| Smart Claim Tools | ✅ Uses tech to prevent L-code errors and track modifier requirements | |
| Faster Reimbursements | ✅ Accelerates high-value claim processing and reduces denials | ❌ Close collaboration needed for best results |
| Full-Service Billing | ✅ Handles everything from auths to appeals for major limb prosthetics |
2. Advance Biller
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Location: Raleigh, North Carolina
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Services: Hemipelvectomy prosthetic billing, custom limb coding, payer compliance
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Customer Sentiment: ★★★☆☆ (Average)
Advance Biller, based in Raleigh, NC, offers hemipelvectomy prosthetic billing services tailored to smaller clinics. They focus on basic claims processing at an affordable price but lack advanced denial management and automation. Their regional expertise suits local providers with simpler billing needs in North Carolina.
| Aspect | Pros | Cons |
|---|---|---|
| Specialized Service | ✅ Experience with complex limb prosthetics | ❌ Limited denial management |
| Affordable Pricing | ✅ Suitable for smaller clinics | ❌ Less support for high-volume billing |
| Local Service | ✅ Raleigh-based with NC regional focus | ❌ Minimal automation in billing processes |
| ❌ Basic client support with slower response times | ||
| ❌ Limited advanced reporting | ||
| ❌ Not suited for rapidly changing payer policies |
3. Paragon Medical Billing
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Location: Asheville, North Carolina
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Services: Hemipelvectomy prosthetic billing, Medicare and BCBS NC claims
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Customer Sentiment: ★★★☆☆ (Steady but slow)
Paragon Medical Billing is located in Asheville, NC, focusing on hemipelvectomy prosthetic claims for Medicare and Blue Cross Blue Shield North Carolina. Their manual processing approach ensures accuracy but results in slower claim and authorization turnaround, making them best for providers accepting longer wait times in NC.
| Aspect | Pros | Cons |
|---|---|---|
| Medicare Expertise | ✅ Deep knowledge of Medicare and BCBS NC billing | ❌ Manual workflows delay processing |
| Local Support | ✅ Asheville-based regional knowledge | ❌ No real-time tracking or analytics |
| Complex Prosthetic Billing | ✅ Skilled at handling limb prosthetic codes | ❌ Slower turnaround on authorizations |
| ❌ Limited scalability for larger practices | ||
| ❌ Less proactive denial management | ||
| ❌ No automation in follow-up processes |
4. Physicians Choice Medical Billing
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Location: Greensboro, North Carolina
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Services: Hemipelvectomy prosthetic billing, complex prosthesis documentation
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Customer Sentiment: ★★★☆☆ (Reliable but rigid)
Physicians Choice Medical Billing, based in Greensboro, NC, offers reliable billing services for hemipelvectomy prosthetics and complex cases. While their documentation is strong, their rigid systems limit customization and flexibility for clinics with varying volumes or specialized needs within the North Carolina region.
| Aspect | Pros | Cons |
|---|---|---|
| Documentation Focus | ✅ Strong medical necessity and K-level support | ❌ Limited workflow customization |
| Regional Service | ✅ Greensboro-based with local area focus | ❌ Less adaptable to low or variable volume |
| Complex Prosthetics | ✅ Experienced with advanced limb prosthetics | ❌ Rigid processes limit innovation |
| ❌ Slow communication and updates | ||
| ❌ Lacks advanced reporting or analytics | ||
| ❌ Minimal proactive denial prevention |
5. Prosthetic Billing Solutions (PBS)
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Location: Durham, North Carolina
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Services: Hemipelvectomy prosthetic billing, custom socket fabrication claims
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Customer Sentiment: ★★★☆☆ (Moderate)
Prosthetic Billing Solutions (PBS), operating out of Durham, NC, provides billing for hemipelvectomy prosthetics and custom socket fabrication. Their service is straightforward but relies heavily on manual claim follow-ups with limited automation, making them suitable for local clinics needing functional but less proactive billing support.
| Aspect | Pros | Cons |
|---|---|---|
| Prosthetic Expertise | ✅ Billing experience with hemipelvectomy devices | ❌ Manual claim follow-ups needed |
| Regional Coverage | ✅ Durham-based with strong local presence | ❌ No real-time status updates |
| Basic Billing Tools | ✅ Covers key prosthetic billing components | ❌ Limited proactive denial management |
| ❌ Lacks advanced analytics and reporting | ||
| ❌ Moderate customer satisfaction | ||
| ❌ Not ideal for clinics requiring frequent billing updates |
6. OrthoBiller
Location: Wilmington, North Carolina
OrthoBiller is a North Carolina-based company in Wilmington specializing in hemipelvectomy prosthetic billing for new clinics. They focus on Medicaid credentialing and basic L-code submissions but offer limited tools for advanced billing or real-time claim tracking, making them best for smaller or entry-level practices.
| Aspect | Pros | Cons |
|---|---|---|
| Medicaid Credentialing | ✅ Supports Medicaid credentialing for new clinics | ❌ Limited denial tracking and aged claim tools |
| Local Presence | ✅ Wilmington-based with good rural outreach | ❌ Does not scale well for multi-location clinics |
| Basic Billing Support | ✅ Provides templates for common billing codes | ❌ Lacks automation and advanced billing software |
| ❌ Not suited for complex hemipelvectomy claims | ||
| ❌ Minimal proactive claim follow-up | ||
| ❌ Low customer service ratings | ||
| ❌ Limited scalability for growing practices |
7. MedClaims NC
Location: Chapel Hill, North Carolina
MedClaims NC is based in Chapel Hill, NC, and specializes in high-volume hemipelvectomy prosthetic billing. They deliver fast claim turnaround using strong software but offer transactional service with little customization or personalized support, better suited for clinics prioritizing volume over relationship.
| Aspect | Pros | Cons |
|---|---|---|
| High-Volume Capacity | ✅ Efficient processing of frequent hemipelvectomy claims | ❌ Transactional service, little customization |
| Fast Turnaround | ✅ Quick claim submission and processing | ❌ No dedicated account manager |
| Technology Support | ✅ Uses robust software for batch submissions | ❌ Limited denial follow-up transparency |
| ❌ Minimal communication on claim status | ||
| ❌ Lacks strategic billing guidance | ||
| ❌ Not adaptable to unique clinic workflows | ||
| ❌ Limited support for complex billing issues |
8. Billing4Prosthetics
Location: Fayetteville, North Carolina
Based in Fayetteville, NC, Billing4Prosthetics is known for expertise in advanced hemipelvectomy prosthetic billing, including powered devices. They excel at HCPCS coding accuracy but have slower follow-up on denials and appeals, with a more reactive approach to client communication.
| Aspect | Pros | Cons |
|---|---|---|
| Tech-Savvy Support | ✅ Skilled in advanced hemipelvectomy prosthetic billing | ❌ Slow follow-up on denials and appeals |
| Coding Accuracy | ✅ High precision in HCPCS coding | ❌ Lack of proactive denial management |
| Authorization Support | ✅ Reliable prior authorization assistance | ❌ Minimal client engagement, hands-off service |
| ❌ Mostly reactive rather than preventive | ||
| ❌ Infrequent updates on claim progress | ||
| ❌ Limited ongoing communication | ||
| ❌ May delay issue resolution |
9. Complete Medical Billing of NC
Location: High Point, North Carolina
Complete Medical Billing, based in High Point, NC, offers cost-effective hemipelvectomy prosthetic billing focusing on limb rehabilitation and post-amputation care. Their hands-off approach leads to limited communication and advocacy, best suited for clinics with straightforward billing needs.
| Aspect | Pros | Cons |
|---|---|---|
| Rehabilitation Billing | ✅ Handles complex limb rehab and hemipelvectomy claims | ❌ Limited client communication and interaction |
| Post-Amputation Care | ✅ Supports long-term amputee patient billing | ❌ Little proactive denial advocacy |
| Affordable Service | ✅ Budget-friendly billing solutions | ❌ Basic claim processing, minimal support |
| ❌ Slow response times for follow-ups | ||
| ❌ No consultation for complex cases | ||
| ❌ Lack of proactive billing issue prevention | ||
| ❌ Limited technology use for claims tracking |
10. NC Prosthetic Billing Experts
Location: Hickory, North Carolina
NC Prosthetic Billing Experts are based in Hickory, NC, providing clear reports and managing hemipelvectomy prosthetic reauthorizations efficiently. Their service scope is limited, lacking deeper involvement in documentation or appeals, making them suitable for clinics needing straightforward billing support.
| Aspect | Pros | Cons |
|---|---|---|
| Clear Reports | ✅ Easy-to-understand billing and claim reports | ❌ Limited specialization beyond hemipelvectomy billing |
| Reauthorization Support | ✅ Proactive claim reauthorization management | ❌ Minimal support for complex documentation |
| Claim Analytics | ✅ Basic analytics for claims monitoring | ❌ Minimal denial support and appeals |
| ❌ Lacks customization for clinic workflows | ||
| ❌ No advanced claim tracking technology | ||
| ❌ Limited customer support | ||
| ❌ Limited scalability for expanding clinics |
11. Blue Ridge Medical Billing
Location: Boone, North Carolina
Blue Ridge Medical Billing, based in Boone, NC, offers affordable Medicare billing for hemipelvectomy prosthetics. They cater well to small clinics but suffer from understaffing, causing communication delays and limited claim updates.
| Aspect | Pros | Cons |
|---|---|---|
| Affordable Service | ✅ Cost-effective Medicare billing solutions | ❌ High staff turnover impacting communication |
| Medicare Expertise | ✅ Knowledgeable in Medicare hemipelvectomy billing | ❌ Slow claim update response times |
| Simplicity | ✅ Straightforward billing for standard cases | ❌ Minimal tech for tracking or reporting |
| ❌ Limited billing scope beyond Medicare | ||
| ❌ Reactive, limited proactive customer service | ||
| ❌ Poor scalability for growing clinics | ||
| ❌ Limited denial management support |
12. Eagle O&P Billing
Location: Winston-Salem, North Carolina
Eagle O&P Billing is a North Carolina-based firm in Winston-Salem offering EMR-integrated billing for hemipelvectomy prosthetics. Known for reliable workflows, clients find the service impersonal and lacking personalized support.
| Aspect | Pros | Cons |
|---|---|---|
| EMR Integration | ✅ Smooth integration with common EMR systems | ❌ Impersonal, corporate-style service |
| Systematic Workflows | ✅ Reliable and consistent billing processes | ❌ Limited hands-on client support |
| Broad Service Range | ✅ Supports many prosthetic components | ❌ Basic reporting, lacks advanced analytics |
| ❌ No proactive denial prevention | ||
| ❌ Little customization of workflows | ||
| ❌ Limited client communication | ||
| ❌ Slow issue resolution |
13. Carolina Medical Billing Services
Location: Cary, North Carolina
Carolina Medical Billing Services, based in Cary, NC, focuses on Veteran Affairs and Medicare hemipelvectomy prosthetic billing. While reliable for routine cases, they have limited capability with private payers and advanced prosthetic technologies.
| Aspect | Pros | Cons |
|---|---|---|
| VA Billing Expertise | ✅ Specialized in VA billing for prosthetics | ❌ Limited to VA and Medicare claims |
| Medicare Knowledge | ✅ Strong understanding of Medicare billing | ❌ Outdated claim tracking and denial tools |
| Stable & Reliable | ✅ Consistent service for veteran clinics | ❌ Poor support for complex or advanced claims |
| ❌ Slow to adapt to new prosthetic tech | ||
| ❌ One-size-fits-all approach | ||
| ❌ Minimal client customization | ||
| ❌ Limited private payer support |
14. O&P Reimbursement Group
Location: Greenville, North Carolina
O&P Reimbursement Group, based in Greenville, NC, provides expert consulting on functional level documentation and L-code bundling for hemipelvectomy prosthetics. Their service is advisory only, lacking full revenue cycle management or real-time claim tools.
| Aspect | Pros | Cons |
|---|---|---|
| Expert Consulting | ✅ Deep knowledge of functional level documentation | ❌ No full revenue cycle management offered |
| L-Code Bundling | ✅ Assists with accurate L-code billing | ❌ Clients must have in-house billers for full service |
| Reimbursement Advice | ✅ Strong reimbursement guidance | ❌ No real-time claim tracking or alerts |
| ❌ Limited ongoing client support | ||
| ❌ Primarily consulting, no billing automation | ||
| ❌ No denial prevention or follow-up tools | ||
| ❌ Not suited for clinics needing hands-on billing |
15. Outer Banks Billing
Location: Kill Devil Hills, North Carolina
Outer Banks Billing is a boutique billing service in Kill Devil Hills, NC, specializing in pediatric and adult hemipelvectomy prosthetic billing. Their personalized care suits small clinics but slow claim processing and lack of tech make them less ideal for larger practices.
| Aspect | Pros | Cons |
|---|---|---|
| Personalized Service | ✅ Tailored billing for small clinics | ❌ Slow turnaround times for claims |
| Pediatric Expertise | ✅ Specializes in pediatric prosthetic billing | ❌ Lacks advanced billing and tracking technology |
| Small Clinic Support | ✅ Close support for small client base | ❌ |
Why Do Hemipelvectomy Prosthetic Clinics in North Carolina Trust QHS for Billing Services?
Quality Healthcare Systems (QHS) leads medical billing for hemipelvectomy prosthetic providers across North Carolina. They handle complex hemipelvectomy billing tasks such as accurate L-code coding, prior authorization submissions, and insurance coordination. This expertise helps clinics secure faster reimbursements and maintain smooth revenue cycles.
QHS submits claims promptly and manages denials efficiently for all hemipelvectomy prosthetic devices, including socket fittings and modular components.
They follow all payer-specific billing rules closely to guarantee full compliance. By choosing QHS, hemipelvectomy prosthetic clinics reduce billing errors and administrative burdens, allowing them to focus fully on patient care.
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.
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Frequently Asked Questions
Why do hemipelvectomy prosthetic clinics in North Carolina choose QHS for billing?
QHS specializes in hemipelvectomy prosthetic billing with expertise in L-code coding, prior authorizations, and insurance coordination, ensuring faster reimbursements and reduced claim denials.
What billing services does QHS provide for hemipelvectomy prosthetic clinics?
QHS offers claim submission, denial management, insurance follow-up, compliance checks, and detailed reporting tailored to hemipelvectomy prosthetic devices and related treatments.
How does QHS ensure compliance with insurance billing for hemipelvectomy prosthetics?
QHS stays updated with payer-specific billing rules and regulations, minimizing errors and audits while maximizing clinic reimbursement.
Can QHS handle complex hemipelvectomy billing scenarios?
Yes, QHS is experienced in managing advanced billing cases, including modular prosthetic components and specialized device codes.
How does using QHS benefit hemipelvectomy prosthetic clinics financially?
By reducing claim denials and speeding up reimbursements, QHS improves cash flow and lowers administrative workload for clinics.
Is QHS familiar with North Carolina insurance providers and regulations?
Yes, QHS has extensive knowledge of North Carolina insurance landscapes, including Medicaid and Medicare requirements relevant to prosthetic billing.
