Medical Billing Error Documentation Log PDF
Track billing errors, amounts, and evidence in one place.
Billing error details
Narrow width. Plain HTML inputs only. No validation logic.
Status message placeholder
Add/remove rows via plain buttons. Empty values allowed.
| Date Identified | Provider / Facility | Account or Bill Number | Type of Error | Amount Affected | Evidence Available | Status / Notes | Actions |
|---|---|---|---|---|---|---|---|
Table-only layout with zebra rows. No conditional null rendering.
🔒 MANDATORY CODEX SAFETY FOOTER (INCLUDE VERBATIM)
Non-Negotiable Guardrails
- Do not modify global layout, header, footer, ads, analytics, or shared components
- Do not import @/components/ui/select or any unverified shadcn components
- Use native HTML inputs only
- Row add/remove buttons must be plain <button>
- No date math, no parsing, no calculations
- PDF builders must return Promise<Uint8Array>
- Always create Blobs using bytesToPdfBlob(bytes) from lib/pdf/bytes.ts
- Never include null in React-PDF style arrays
- No refactors
- Tool may only break itself