Insurance Prior Authorization Denial Log PDF
Track denial dates, reasons, and appeal needs for each authorization request in a narrow PDF table.
Denial entries
Narrow table to avoid ad overlap. Add rows for each denial.
| Denial Date | Insurance Company | Service / Procedure Requested | Provider Name | Reason for Denial | Appeal Required | Status / Outcome | Notes | Actions |
|---|---|---|---|---|---|---|---|---|
Download a narrow denial log PDF to attach to appeals.
🔒 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
Safety notes
- Processing stays in your browser. PDFs generate locally—no uploads or accounts.
- Downloads use a secure PDF blob helper (no raw array buffers or workers required).
- Review details before sending; nothing here is legal advice or a substitute for local forms.