Effective January 1, 2026, UnitedHealthcare (UHC) requires many Medicare Advantage HMO plan members to have a primary care provider (PCP) referral submitted through the UHC Provider Portal before specialty care, including cardiology.
These requirements are established by UnitedHealthcare and apply to all cardiology providers, including Arkansas Heart.
Referrals are valid for six (6) months and must be renewed every six months for ongoing cardiology care.
For Patients with a UnitedHealthcare Medicare Advantage HMO plan:
- UnitedHealthcare requires a PCP referral on file before Arkansas Heart can provide cardiology care
- Your appointment cannot move forward unless the referral has been submitted and is active in the UHC system
- To avoid delays or rescheduling, please confirm your referral is completed before your appointment date
What You Need to Do
When cardiology care is recommended:
- Contact your primary care provider’s office
- Ask them to submit a cardiology referral to UnitedHealthcare through the UHC Provider Portal
- Confirm the referral was submitted before your appointment
- Bring your insurance card to your visit
Important: Arkansas Heart cannot submit referrals on a patient’s behalf.
If helpful, you may download and share our referral explanation letter with your PCP’s office.
For Referring Providers
Please submit a cardiology referral through the UHC Provider Portal for patients enrolled in UnitedHealthcare Medicare Advantage HMO plans prior to the their appointment at Arkansas Heart.
Please ensure the referral:
- Is submitted and active before the scheduled appointment
- Lists an Arkansas Heart physician or APRN as the referred?to provider
- Includes the diagnosis and reason for visit
- Includes the maximum allowable number of visits with an appropriate six?month date range (to reduce repeat referral requests)
Note: Faxed referrals or clinical documentation alone do not satisfy UnitedHealthcare referral requirements without portal submission.
Referral Process Notes
- Referrals become effective once confirmation is generated in the UHC system
- A start date may be entered up to 5 calendar days prior to submission, if needed
- Referrals are separate from prior authorization; some cardiology services may require both
Scheduling Appointments at Arkansas Heart Hospital
To help appointments proceed smoothly:
- Patients should request their PCP submit the referral before scheduling or immediately after scheduling
- Referring offices should submit referrals prior to the date of service
Arkansas Heart schedulers may need to verify an active referral before confirming or maintaining appointments.
Frequently Asked Questions
Why is a referral now required when it wasn’t before?
UnitedHealthcare updated its Medicare Advantage HMO rules effective January 1, 2026. Most specialty care now requires a PCP referral for coverage.
Does this apply to UnitedHealthcare PPO plans?
No. These requirements apply only to UnitedHealthcare Medicare Advantage HMO plans.
What happens if a referral is not on file?
Appointments will need to be rescheduled until a referral is active in the UnitedHealthcare system.
Further Assistance
- Referral submission questions: Contact the patient’s PCP office
- Appointment or scheduling questions: Contact the Arkansas Heart Scheduling Team at 501-664-5860
- Insurance benefit questions: Contact UnitedHealthcare using the number on the back of the member’s ID card
This page is intended to support both patients and referring providers in preparing for cardiology visits at Arkansas Heart Hospital. Coverage is governed by the member’s UnitedHealthcare Evidence of Coverage (EOC).