Brain Boost Breakout

International

1

Liaison Assistance Request Form Details:

Laboratory: Sacramento

Department Needing Assistance: International Partners ((Korea, Singapore, Brazil, Alhambra)

Type of Request: International Assistance (Korea, Singapore, Brazil, Alhambra, Wetherby)

Accession Number(s): 8208570003 - NOAH KHOO

Details of Request: Customer submitted the wrong patient's name to 8208570003. The correct patient's name should be Johah Khoo - MC# 900219000521009.

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]; [e-mail]

Please let the LYNXX team Know, Monica and Amber.

Were you aware of the LYNXX team before this?

Information on the team is accessible on our Sharepoint page.

2

(Start at the bottom)

From: SacramentoPSMcommunications <[e-mail]>
Sent: Thursday, July 16, 2026 2:10 PM
To: SacramentoPSMcommunications <[e-mail]>; Murphy, Tim <[e-mail]>; NALabLiaisons <[e-mail]>
Subject: RE: FT4E - BONELLO, Ruby

@NALabLiaisons can you please assist in helping to track down this accession in Vet connect?

Thank you,

Michelle Chiu | Medical Laboratory Technician I

IDEXX Laboratories | 2825 KOVR Dr. West Sacramento, CA 95605

From: SacramentoPSMcommunications <[e-mail]>
Sent: Thursday, July 16, 2026 11:03 AM
To: Murphy, Tim <[e-mail]>; SacramentoPSMcommunications <[e-mail]>
Subject: RE: FT4E - BONELLO, Ruby

Hello,

I can’t seem to find this patient either. Do you have a tracking number for the shipment?

Thank you,

Michelle Chiu | Medical Laboratory Technician I

IDEXX Laboratories | 2825 KOVR Dr. West Sacramento, CA 95605

From: Murphy, Tim <[e-mail]>
Sent: Wednesday, July 15, 2026 8:19 PM
To: SacramentoPSMcommunications <[e-mail]>
Subject: FW: FT4E - BONELLO, Ruby
Importance: High

Hey,

Sorry just chasing an update for the below.

Tim Murphy  | Laboratory Supervisor PSM & Referrals

IDEXX | 10 Brandl Street, Eight Mile Plains QLD 4113 |

 M +0407-922-450 | P 07 3456 6066 | www.idexx.com

We help pets lead longer, fuller lives + + + + + + +

From: Murphy, Tim
Sent: Wednesday, July 15, 2026 10:50 AM
To: SacramentoPSMcommunications <[e-mail]>
Subject: FT4E - BONELLO, Ruby

Hey SAC Team,

We sent this serum to you, which I believed was received at the end of last month. There doesn’t appear to be a record of it in our vet connect records (7419). Is it possible it may have been run under an unknown name? Our reference number is 4001161022.

Thank you for any assistance

Tim Murphy  | Laboratory Supervisor PSM & Referrals

IDEXX | 10 Brandl Street, Eight Mile Plains QLD 4113 |

I was able to locate a patient with the same name doing a LYNXX search. The scanned requisition showed an Australian form, however the LIMS assigned was 4719 instead of 7419.
------
Sometimes the most intimidating issues have the simplest answer, and even in cases where a name search should have been performed already, we should know that doesn't always happen.

One thing that aided me in resolving this case was recognizing it was an international request, even though it never explicitly states so. Tim's address being QLD - I assumed Queensland, and confirmed using his personnel card and location in Teams

3

Liaison Assistance Request Form Details:

Laboratory: Sacramento

Department Needing Assistance: International Partners ((Korea, Singapore, Brazil, Alhambra)

Type of Request: International Assistance (Korea, Singapore, Brazil, Alhambra, Wetherby)

Accession Number(s): 8208500944

Details of Request: Please advise which test code to follow up, 1933 or 2860, please share the price of the test.

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Is there an active email chain for this issue?: No

Supply the prices per SC, Dr. Rachel Kilroy is our medical contact for international requests. She recommended TC 1933, which we added per SG request. However then we had a pathology follow-up

"“We will be updating test code from 1933 to TC 2860 for the client to prevent delay. TC 1933 is exclusive to cytology cases. TC 2860 is intended for biopsy samples – the pathologist also recommended this in their report. “

(Dr. Kilroy for international medical requests, and always be ready for any issue to come back up! Even Drs are fallible)

4

From: idexx-HK-customer-service <[e-mail]>
Sent: Friday, July 17, 2026 1:28 AM
To: NALabLiaisons <[e-mail]>
Cc: idexx-HK-customer-service <[e-mail]>; CEN Internal Customer Service <[e-mail]>
Subject: Ref lab Tests - HONG KONG

Hi Liaison Team,

For Hong Kong customers, could I request that the team to send an email to [e-mail] whenever there are any issues with HK lab tests?

Currently, HK customers may not be aware of test related issues because they do not log in to VetConnect Plus every day unless we contact them directly. It would be greatly appreciated if the Liaison Team could inform us proactively of any test issues before customers discover them themselves. This would help us communicate with customers promptly and avoid unnecessary delays.

Thank you for your support.

Good morning, all,

Bringing in @LLManagement to review this workflow request. Thank you!

Much appreciated!

 

Please REPLY ALL when answering this request.

For NEW requests to the NA Lab Liaison Team, please submit the NA Lab Liaison Request Form.

 

Spencer Doehlert | Grafton Liaison – Customer Support Consultant III

Send-Outs

1

Escalation Reason: Reason Not Listed

Lab Name: NORTH GRAFTON-23

Accession Number: 2116203600

PCR: No

Comments: tc 1314 - pls finalize report - not able to complete test 

[[From DOS]]Storage/Stability

A sample frozen at the clinic prior to submission is the most stable. Refridgerated samples shipped on ice are stable for 48 hours.

(Send-outs testing was pending)

There are lots of ways to start this one.Reaching out to send-outs is an absolutely acceptable way to begin, but is there further information available?
----
Good afternoon,

I am not seeing an NTRLAC, just the delay notification.

From a previous email to customer facing teams -

“February 19, 2026 - Due to reagent supply issues, our aldosterone assays (baseline, 20002 and post-, 20009) are temporarily unavailable"

(Verify that you're seeing the same thing CTS is; send-outs can have unusual NTRs. Various delays are possible at third party labs, from reagant issues to weather events. Read your emails! They're very easy to mark as read and move on from, but even if you don't remember them exactly, having it in your memory for you to then look up is an opportunity!)

2

Escalation Reason: Obtain Status of Results

Lab Name: NORTH GRAFTON-23

Escalation Sub-Reason: Provide TAT (Missed TAT)

Accession Number: 2318795569

PCR: No

Test Code: 2451

Add On: Yes

Add On Date/Time: 5/14

Expected TAT: 5/18

Comments: Hello, the client is requesting an update on the fructosamine, stating that it's taking too long and they would like to know why and also, when it will be released?  Thanks in advance.

Escalation Notes:

Check the test tracking! After reviewing it I sent the below message to the lab.

Good morning, all,

An AO Fructosamine was added to 2318795569 on the 14th, looking at logs possibly right after Send-Outs pulled it to ship, which meant it was missed here. However there’s been no NTR sent to the client; is there any chance the third party lab could complete the Fructosamine? Or could we please NTRLAC and investigate why this might not have shown up on pending? Thank you all!
------
Tests that are added and missed as the sample is being prepared for shipment is a definitely possibility, whether to another lab or send-outs, and something to watch for. Third party labs are able to complete some missed tests. Lab should investigate why not pulled on pending.


Additionally, it was my experience and familiarity with my lab, both personnel and workflow, that allowed me to identify what had happened. Talk to people and learn about how they work! Is there a department you're interested in? Ask a supervisor if they'd be willing, or might find someone who could schedule a walk through of the department!

3

@Doehlert, Spencer do you have any insight on this note in LYNXX? Did they update the MC number? “please also relay the correct MC# to protatek”

Thank you,

Kelsey Gagner | Reference Labs Operations| Lab Associate Sr III

IDEXX Laboratories, Inc. | 3 Centennial Drive, North Grafton, MA 01536|

From: Jing Sui <[e-mail]>
Sent: Tuesday, July 21, 2026 2:57 PM
To: Grafton Send-Out Results <[e-mail]>
Cc: PRL <[e-mail]>
Subject: please clarify MC# for 4409672333

Hi,

Could you help to clarify the MC# for Idexx case 4409672333. It seems one extra digit was included.

"Looks like clinic is in the process of getting the correct number."


(See image in key. Using ServiceCloud to clarify LYNXX notes is a common occurrence. Particularly when multiple add ons are sent on the same accession CTS has no ability to see what order they were sent in. Use timestamps to clarify the latest request and if there's any conflicting information)

4

Liaison Assistance Request Form Details:

Laboratory: Markham

Department Needing Assistance: Laboratory Send Out

Type of Request: 3rd Party Customer Contact Needed

Accession Number(s): 6400690279

Details of Request: DCM2 has been resulted. Please reach out to the client and let us know if they want DCM1 to be run as well.

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Is there an active email chain for this issue?: No

If you don't understand something, ask questions! In this case I examined the requisition, and saw that DCM1 was the initial test the client ordered.

"Hi Elaine,

Could I please ask for some further clarification? I see the DCM1 was ordered on the client's requisition. Was the DCM2 completed in error? Should we not be completing the DCM1 automatically, as it is what the client ordered. Are we still able to complete the DCM1 with the sample remaining?"

-----------------------------------------------------------
Hello Spencer,

 

Accession 6400690279, TC DCM is selected and we usually order DCM1 only.  However, DCM2 was performed with result released to the client.

We wanted to follow up regarding the dog's DCM genetic testing. The UC Davis Veterinary Genetics Laboratory confirms that DCM1 and DCM2 are two separate genetic variants, and each requires its own test.

If a dog is negative (N/N) for DCM2, this does not provide any information about its DCM1 status. A dog without the DCM2 variant may still:carry the DCM1 variant, be at risk (N/DCM1 or DCM1/DCM1) or be completely clear (N/N for both)

Both variants also have incomplete penetrance, meaning that carrying one of them increases risk but does not guarantee disease.

Since we only received DCM2 results for 'Max', the client may wish to consider completing the DCM1 test as well in order to obtain a full understanding of the dog’s genetic risk for dilated cardiomyopathy.

Please let us know if you would like assistance arranging the DCM1 test or if you have any questions.

(In this case a very simple request hid a much larger issue. Trust your instincts and ask questions, as you gain more experience you will be able to say "That doesn't seem quite right". I also asked Liaison leadership to review this case with me to make sure I was taking the correct approach)

Micro and Pathology

1

Liaison Assistance Request Form Details:

Laboratory: Memphis

Department Needing Assistance: Laboratory Microbiology

Type of Request: Verify Testing Needed

Accession Number(s): 4614666250

Details of Request: Good afternoon, This accession was completed on 3/19/26 for TC 3860. Both the left and right ears were planted together due to the MICRO SOURCE: Both- Ears. TC 3862 was added to the same accession on 3/20/26 for the client to be planted separately as they asked for the wrong test. Do we need to have a separate accession for this new test code as it has already been completed? Please advise.

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Is there an active email chain for this issue?: No

For workflow questions please refer to lab leadership.

("Is this something we should be doing?" is always a good question to ask. This is specifically a workflow question, and, as Heidi advised recently, is not within our purview. As you can see from the AO the client clearly does want a two sit culture, so there is not a question to clarify with them. If there were confusion about what the client was asking for it would be appropriate for us to reach out.)

2

From: Microsoft Power Apps and Power Automate <[e-mail]>
Sent: Tuesday, March 24, 2026 1:21 PM
To: NALabLiaisons <[e-mail]>
Subject: Liaison Request | 03/24/2026 | Elmhurst | 8108525124 | Verify Testing Needed

Liaison Assistance Request Form Details:

Laboratory: Elmhurst

Department Needing Assistance: Histo Path Bench

Type of Request: Verify Testing Needed

Accession Number(s): 8108525124

Details of Request: Hi. Client ordered 601017, 7217, and Histoliv1. We have 2 GI punch biopsies, a whole spleen, and liver wedges. Please confirm which tech they would like. We cannot run histoliv on the whole spleen.

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Good morning! Could you please provide a bit further clarification? It looks to me like the spleen is the submitted source for the whole biopsy, the liver for the histoliv, and the

(Always examine documentation [Check the Req!].)

3

Liaison Assistance Request Form Details:

Laboratory: Baltimore (Glen Burnie)

Department Needing Assistance: Clin Path Bench

Type of Request: Verify Sample Submitted

Accession Number(s): C21-16597092

Details of Request: I sent an email to path ops, requesting clarification on the pathologist rework; her answer is below; The clinical history indicates 2 separate masses/lesions. Three of the slides look like a mass and the rest look like a lymph node. I think this should be a 2 or 3 site cytology instead of 2801depending on how the slides are labeled. Thanks Lily These are the notes from NP, we don't know what M1, M2 and M3 stand for, and all the slides are labeled as "Abd mass" Please separate out the 2 sites and change test code to 2801 ledwards 05/22/2026 12:42:12 All slides are labeled "Abd mass" , slide A2 & A5 labeled "M1", A3 & A6 "M2", and A4 and A7 "M3" skennedy 05/20/2026 14:45:13 Unsure on how to proceed. Thank you

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Is there an active email chain for this issue?: Yes

Good afternoon, all,

Please consult department/lab leadership on next steps, the liaison team is unable to advise on pathology workflow. If after that consultation the team concludes a need to request clarification on sample labeling that is something my team is able to assist with.

Much appreciated!

(This is a direct request for workflow guidance, which we cannot help on. But always polite, and welcome a follow up we are equipped to handle. In this case leadership did request that I call and clarify the 'M' labels, which ended up being the Dr.'s tracking system for himself as he makes slides, and not relevant to the source.  )

4

Laboratory: Elmhurst

Department Needing Assistance: Histo Path Bench

Type of Request: Verify Testing Needed

Accession Number(s): 6400705790

Details of Request: Hello, we received tissue in formalin and fresh tissue of liver, which in this case we would send out an APNTR to see if any other testing is wanting to be done before the tissue is transferred to formalin. However, the fresh tissue was accidentally dipped into formalin, which prevents any other testing able to be done on it. Can the clinic please be contacted to inform them and confirm testing?

Subject: RE: Liaison Request | 04/10/2026 | Elmhurst | 6400705790 | Verify Testing Needed

Hello,

I am a bit confused by the ask. Can you please confirm what the NTR that is normally released says? It seems like since there was a 7 site biopsy ordered and 7 sites were submitted, the customer would understand that the sample will be used for that testing. I would think contacting them to let them know of the error would be an unnecessary dissatisfier especially if we are able to proceed with the testing originally ordered. I think it would just be best to add this information to the LYNXX notes in case the customer calls in trying to add any testing. Am I missing something here? Please explain in detail if so, I would like to be sure I understand the ask.

**Please reply all when answering this request.**

For NEW requests to the NA Lab Liaison Team, please submit the NA Lab Liaison Request Form.

Thank you!

Sarah Martelli (she/her)| Customer Support Consultant, Louisville Lab Liaison

(Do not be afraid to ask questions! Is this something we should be proactively calling about? Request more eyes and use your judgement)

5

Liaison Assistance Request Form Details:

Laboratory: Jacksonville

Department Needing Assistance: Laboratory Send Out

Type of Request: Safety Concern (Extreme Cases Only, all others please order NTR)

Accession Number(s): 5100281998

Details of Request: Client submitted a LARGE Mammary chain which was PACKED/ JAMMED in an unlabeled GLASS mason jar. Please advise client to use Large Tissue Submission Bags for this type of situation. Staff properly repackaged sample for traveling throughout the network.

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Is there an active email chain for this issue?: Nocan

How do we approach calling about a safety issue?

"We only wanted to draw attention to it out of abundance of caution, to ensure sample integrity and the safety of everyone involved from transport to processing the sample"

Emphasis the human concern, but we're also interested in protecting their samples as well.

"Out of concern for sample viability"

LL Request Form

1

Liaison Assistance Request Form Details:

Laboratory: Sacramento

Department Needing Assistance: Pathology Operations 

Type of Request: Testing Priority (avian, exotic, zoo, pocket pets only)

Accession Number(s): 8208506949

Details of Request: Dr Steven asked for faster result , because he needs to plan the treatment plan this patient. Please follow up for Dr Steven Chan

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Is there an active email chain for this issue?: No

Proceed as requested, but opportunity to recognize actually international request. Would pathops request a stat to a pathology sample?

(Who is asking? Forms may be filled out inaccurately)

2

Liaison Assistance Request Form Details:

Laboratory: Memphis

Department Needing Assistance: Patient Sample Management

Type of Request: Request Not Listed ( Please evaluate all other options before selecting)

Accession Number(s): 4614895132

Details of Request: On the Miscellaneous report for acc 4614895132 the client stat send\fax to request but nothing was sent. Please help.

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): nothing

Is there an active email chain for this issue?: No

We can often receive requests without context. Do what you can by researching in LYNXX and SC to see if there's something you can glean, but always ask for more.

3

Escalation Reason: Reason Not Listed Lab Name: NORTH GRAFTON-23 Accession Number: 2318487456 PCR: No Comments: Hello, validity request placed yesterday for this accn asking sample to be ultracentrifuged to help with lipemia and to rerun testing after this. DVM is now calling in as they see validity was completed but they question if their request was met. can we please confirm if this sample was ultracentrifuged before running validity - if so can we please release a comment stating it was IF it was not are we able to please do so. this DVM is super adamant on this. and stated it has been done in the past with zero issues. Escalation Notes:

Good morning, all,

Could I please ask for assistance, with this request for a validity we performed yesterday on 2318487456? Does seem a bit odd to me to perform a validity with a different prep, however they seem to state it has been done before, so any assistance would be appreciated. Thank you!

“notes here"

can we please confirm if this sample was ultracentrifuged before running validity - if so can we please release a comment stating it was IF it was not are we able to please do so. this DVM is super adamant on this. and stated it has been done in the past with zero issues.”

(Get to know whom to speak to about certain issues. Our good relationship with the lab is one of the most valuable tools we have. Approach openly, request help. People like to be useful!)

4

Liaison Assistance Request Form Details:

Laboratory: North Grafton

Department Needing Assistance: Patient Sample Management

Type of Request: Request Not Listed ( Please evaluate all other options before selecting)

Accession Number(s): 2318471289

Details of Request: Hello This we received a department level coaching for this accession but the complaint isn't something that a PSM tech would be responsible for. We have no way of requesting specific antibiotics this would be something missed by the micro tech.

Hi Vince!

Can’t see too much activity on our end but definitely think you may have a point, if you’d please check the coaching form, there should be instructions to follow-up with I believe the data people with a dispute, we’re unable to assist on this one.

Much appreciated!

 (A not uncommon email we get, guide to correct resource if an option, and become familiar with common requests we see outside our purview)

Miscellaneous Escalation

1

SAP 243578 - Escalation - Reason Not Listed - CALGARY-64

 Comments: does UNA/A/V includes CYSB? UNAI does... Escalation Notes:

"Good afternoon, TC Info is not within our purview, I am not certain, personally, and we only have the same SC resources as yourself. Thank you! "

(If you're aware, feel free to help, but do we have a separate resource?)

2

Liaison Assistance Request Form Details:

Laboratory: Greensboro

Department Needing Assistance: Laboratory Gen Lab (Hematology, Chemistry, UA, Endo, Allergy, Immunology, Serology, Parasitology)

Type of Request: Verify Testing Needed

Accession Number(s): 4511514425

Details of Request: this accession is on our add on list but we are uncertain of what is being asked

[(NOTES FROM LYNXX) IBA -- customer already has BioAnalytics account under SAP 293898 -- Sam Andreski -- 336.288.3769 Ext 1335 -- [e-mail] ]/[[Corrected SAP in request to 293898]]

Request Sent by: [e-mail]

Please send any follow up communication to the following email address(s): [e-mail]

Is there an active email chain for this issue?: No

Hi China,

IDEXX Reference Labs has stopped all pathology testing for non-human primates, however they do have the ability to submit these samples under the Idexx BioAnalytics side of the company, and the samples will need to be shipped to them in either our Grafton or Sacramento. If you’d please work with your lab leadership on workflow, this will likely be a request we will see again in the future.

(Search your emails for past updates! We may be more in the loop to changes than bench personnel. Point to lab leadership for actual workflow)

3

Escalation Reason: Final Report Issues

Lab Name: NORTH GRAFTON-23

Escalation Sub-Reason: Other Report Issues

PCR: No

Accession Number: 2317026191, 2317264845,2317829972, 231849905

Test Code(s): 72499, 4379, 3967,4871

Comments: Please advise why the corrected report on three accessions:

Accession: 2317026191 for Willow Coller, test code 72499, 4379 and 9970

Accession: 2317264845 for Clover Leblanc, test code 72499 and 3967

Accession: 231849905 for Kiwi Wilson, test code 3967 and 72499

A simple request to complete, but how do we communicate it? Write our own request or cut and paste?

"I’ve been asked to help with a trust results case, the client has had three Lymes corrected from negative to positive and is wondering if we have any insight into why the change in these cases. Could we please take a look back and see if we notice anything unusual? Please let me know if there is a master tech I should tag as well.

2317026191 for Willow Coller, 9/17/2025

2317264845 for Clover Leblanc, 1/10

231849905 for Kiwi Wilson, 4/8"

(When liaising we can use our communication skills to make things more collaborative)

4

(Change in format, this is my inquiry)

Subject: 4511339498 | 2208 TAT Concerns | SAP 447339 | CASS Inquiry

Good morning, Anil,

I'm a liaison supporting the corporate account support team, and reaching out about a concern MedVet Atlanta had about TAT for TC 2208, Chemistry Panel 4 with CIALP and Mg—Canine. Under TAT we have "3-5 days for CIALP; preliminary results by 8:00 a.m.", however this client submits samples to Greensboro, and with them not equipped to perform CIALP the entire panel transfers to Sacramento, and taking a day to ship causes us to miss the stated 8am preliminary results. 4511339498 is our current example accession.

I had hoped we could keep the chemistry panel in Greensboro and transfer the CIALP only, however IT when asked stated that we are unable to split locations and you might be able to provide more insight. This would imply to me the solution might be to remove the 8am portion from the TAT info, however I'm interested if you have any other ideas on how to make sure that we're meeting our promised goals. Thank you!

Notice how I proposed a solution, but asked for their thoughts. This then led to back and forth between Tech Ops and the lab, where Anil, despite being the resource for change, was incorrect about the LYNXX workflow. Stay patient and on course and you'll eventually get results
---

Hi Anil,

Yes, I remember this sample, the Magnesium was run at Greensboro, but the rest of the panel LYNXX had located to SAC, and by the time we found it in LYNXX, the sample had already been pulled for its sendout so we weren't able to relocate the rest of the panel to Greensboro. But it was LYNXX that had located everything but Magnesium to Sac. Test Tracking showed that the portion of the accession that was Collection Code 2240 was automatically put as a transfer to SAC when the sample was accessioned, and I just pulled up that Collection Code under our Master Data here in Greensboro and it's marked as a transfer to SAC under Master Data

-------------------------

Hi Anil,

I redirected this to IT Lab Ops as they can change the transfer locations and it does not need MDG. To note: This contains CIALP, which is why it was transferring out of Greensboro. Test and Panels are set up to transfer, but not at the assay level.

Best,

Sarah Leder (she/her)  | Global LYNXX Master Data Governance Manager, Business Analyst III

IDEXX | OH-virtual | m. 614-601-2701 | idexx.com

:

_______________

5

Case # 14932966 - no accession

Dr.'s Q: Client called in asking what the lab would default the TC/charge to if they went over their 2 month allotted Professional Interest Cytology's a month (TC 650)

*Thanks to Shyla*

Steps I took to find the answer:

• Asked Giselle since she's on our Clin Path STP Team - she recommended I email Path Ops
• Emailed Path Ops - They stated they did not think this TC was changed at the lab level and confirmed that they do not
• Emailed Billing to see if this TC is one they monitor and did they adjust billing after the month was over to identify if they submitted more than the 2 per month per Dr. "limit" - They stated they don't monitor this and don't change TC's. They process whatever TC the lab attached to that account. 
• Discussed with Maren - I posed the idea that I since it didn't sound like this TC was monitored and billing was not adjusted, that it could be a TC on the Honor System. She agreed and felt that's how I should respond. I added to my response that it's possible billing would make adjustments if they felt this TC was being abused. (Because I didn't want to say Billing isn't monitoring this, just that billing doesn't make adjustments when it's not abused each month) This way I was hoping the customer would get that in a more urgent need, that they can submit a 3rd TC 650 in a 1 month time frame under the same Dr. if they really had to and wouldn't be billed any more, however also hoping to help them keep the idea that there's still a limit and they should respect that. 

So NO actual answer to this Q, but I went through many people and departments and agreed on a reasonable answer for the customer.