Which of the following is not a valid status for a patient referral?

The status of a patient referral provides critical insights into the process and progression of the referral system. Each status plays a specific role in tracking whether a referral has been successfully initiated, acted upon, or if there are barriers to progress.

In this context, "Completed" is indeed a valid status, indicating that the referral process has been finalized and the patient has seen the referred provider. The other statuses—such as patient refusal, canceled, and awaiting insurance—clearly denote specific scenarios regarding the referral's current state, whether they indicate obstacles or actions taken with respect to the referral.

By contrast, every other option reflects a situation that requires attention or follow-up. A referral being marked as "Patient refusal" indicates that the patient chose not to pursue the referral. "Canceled" shows that the referral will not proceed for some reason, and "Awaiting insurance" implies that the referral is pending because of insurance approvals. Therefore, the choice indicating "Completed" does not convey any ongoing status or issue and is thus not appropriate as a valid status beyond its affirmative conclusion.