Irish Life Health claims time limit: the 36-month rule

What the 36-month rule says

The rule is in Irish Life Health's Terms and Conditions for Payments to Consultants, in force from 17 June 2026. Clause 5.7 reads:

"All professional fee accounts must be submitted within thirty-six (36) months of the discharge of the Member for payments in full as per the Terms and Conditions of this agreement. For professional fee account submissions made more than thirty-six (36) months after discharge of the Member; these will not be payable by ILH, and the Member may not be billed for such services unless cases of genuine error or hardship occur, which will be reviewed upon request on a case-by-case basis."

Question	Answer under clause 5.7
How long do I have?	36 months from the member's discharge
What if I miss it?	Irish Life Health won't pay the account
Can I bill the patient instead?	No, unless there is genuine error or hardship
Who decides on error or hardship?	Irish Life Health, on request, case by case

A late account doesn't change whether you are a participating or standard-rate consultant. It simply isn't paid, and the fee can't be moved onto the patient.

Why a three-year window still catches practices out

Three years sounds generous. The accounts that miss it are rarely the busy ones. They are the ones that got stuck: a claim form waiting on a signature, a query that nobody answered, a patient whose details changed, or a procedure done at a second hospital that never made it onto the rooms' list.

Most of these are found late because nobody is looking for them. The fix is a regular check, not a faster one. Our guide to why health insurance claims get rejected in Ireland covers the other timelines that trip up claims, across the insurers.

Participating benefits and balance billing

Irish Life Health's 2026 General Ground Rules say participating benefits are paid to consultants who join the full cover scheme. Those amounts are "in full and final settlement" of the patient's bill, including the reports needed to finalise it, and participating consultants agree not to balance bill the patient.

So, for a participating consultant, the Irish Life Health payment is the fee. If the account is late, there is usually nothing left to collect from anyone.

The schedule changes four times a year

Clause 3.5 of the consultant terms says Irish Life Health may amend the Schedule of Benefits "in September, December, March and June each year" and publish each version on irishlifehealth.ie. The consultant is bound by the most recent published schedule, and "continued submission of claims after an update date will be deemed acceptance of the updated Schedule."

In practice that means two things for the rooms:

• Check the current schedule on irishlifehealth.ie after each of those months, rather than relying on a saved copy.
• Code each claim against the schedule that applies to it, and don't reuse old codes or rates from memory.

A simple routine for the rooms

None of this needs new software. It needs a list and a date in the diary.

• Every week: match the clinic diary and theatre lists against claims sent. Anything done but not claimed goes on a list with a name beside it.
• Every month: go through every Irish Life Health claim that's still open or queried. Note why each one is stuck and what is needed next.
• Every quarter: after the September, December, March and June updates, check the schedule for any codes you use often.
• Any account over 30 months old: move it to the top of the list. That leaves time to sort out a signature or a query before month 36.
• Keep the paperwork moving: letters and procedure notes signed promptly make claims quicker to finish.

Some practices hand this to a billing agency; others keep it in the rooms. Our comparison of medical billing companies in Ireland and in-house billing sets out both.

Where Ask Brigid fits, and where it doesn't

Ask Brigid doesn't submit insurer claims. Your team still sends Irish Life Health claims through Irish Life Health's own channels.

What Ask Brigid does is keep the rest of the paperwork in one place: one diary across your rooms and hospital sessions, consultation dictation in the patient's record, and invoices with card payment by link for patients paying themselves. Unpaid invoices stay in view for your team to chase. That makes the weekly check easier, because the list of what happened is already in one place.

Next step: this week, pull every Irish Life Health account more than 30 months past discharge and check where each one stands.

Ask Brigid is looking for a small number of founding consultant practices. Explore the sample practice (the real app, invented patients, no sign-up) or request early access.