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Required Paperwork:
When a patient comes for their first visit, they will need to fill out all required paperwork and be sure to bring their insurance card and a doctor referral or prescription if required by their insurance. If you would prefer to fill out all paperwork before you arrive, all of the forms are available to download below. Most of our forms require Adobe Acrobat; you may download it HERE for free.
Orthotics paperwork (For orthotics only)
Insurance FYI : When you schedule your first appointment, the front office staff should find out what benefits are available to you. If a prescription or referral from your primary health care provider is required under your insurance plan, you will need to obtain one. In order to coordinate your care most effectively, we encourage patients to obtain required prescriptions or referrals before they come in for their first physical therapy evaluation.

After the examination, your physical therapist (with the guidance of your primary physician) will be able to predict the necessary treatment interventions and a general timetable of treatment. If it appears that the available insurance benefit will not cover the needed therapy, your therapist will recommend options that are available to you (for example, direct out-of-pocket payments or other arrangements). Your understanding of any benefit restrictions early in the therapy process will ensure fewer misunderstandings later and typically better outcomes.

Most of all, active participation in your physical therapy program will facilitate achieving optimal outcomes of care. Your therapist will give you homework (an at-home exercise program) that may include stretching or strengthening exercises as well as changes to make at your work station. If you are the caregiver for a family member, the therapist may instruct you in safety techniques and adaptations to make in the home environment. Your commitment and active participation in your program may shorten the overall length of therapy, and this will be helpful if the health care benefit is restrictive as to the number of visits available.

Note: Attention all United Healthcare, Pacificare, Definity Health, and SecureHorizons patients. As of December 1, 2008 we will no longer be contracted providers with these insurance plans. If you are currently receiving treatment and hold a policy with one of these companies, your benefit levels will likely change. Please call our office to discuss your options or if you have any questions regarding this change.

Accepted Insurance Plans:
  • Aetna
  • CIGNA
  • Blue Cross/Blue Shield
  • Definity Health - (until 12/1/08)
  • First Choice Health Network
  • PacifiCare - (until 12/1/08)
  • Premera
  • Regence
  • Uniform
  • Auto Insurance Companies
  • Labor & Industries
Helpful Insurance Vocabulary:
Provider: One who delivers health care services within the scope of a professional license.
Member: A term used to describe a person who is enrolled in an insurance plan; the term is used most frequently in managed care.
Reimbursement: Refers to the payment by the patient (first-party) or insurer (third-party), to the health care provider, for services rendered.
Policyholder: Purchaser of an insurance policy. This is usually the employer who purchases policy coverage for its employees.
Co-insurance: In indemnity, the monetary amount to be paid by the patient, usually expressed as a percentage of charges.
Co-payment: In managed care, the monetary amount to be paid by the patient, usually expressed in terms of dollars.
Deductible: The portion of medical costs to be paid by the patient before insurance benefits begin, usually expressed in dollars.
Denial: Refusal by insurer to reimburse services that have been rendered; can be for various reasons.
Eligibility: The process of determining whether a patient qualifies for benefits, based on factors such as enrollment date, pre-existing conditions, valid referrals, etc.
Gatekeeper: Refers to the provider designated as one who directs an individual patient’s care. In laymen’s terms, it is the one who refers patients to specialists (e.g. physical therapists) for care.
Benefit Language: Defines who is eligible to receive care, how much care they can receive, and in what time period the care can be rendered. The language can either be very restrictive or all-inclusive. Courtesy of APTA
Cancellation Policy:
ESRC asks that all patients give at least a 24 hour notice before canceling appointments unless due to unexpected illness or emergency. Our therapists value your time and we request that you value theirs.

The first two appointments not kept, cancelled, and/or rescheduled at least 24 hours prior to the scheduled appointment time will be charged $50.00. The third and all subsequent appointments not kept, cancelled, and/or rescheduled at least 24 hours prior to the scheduled appointment time will be charged $100.00 each. These charges cannot be billed to your insurance company and will be your responsibility. Missed appointment fees must be paid at the next scheduled appointment.
If you are not able to make your appointment, call us to reschedule at (425) 576-8180.
When to Arrive:
New patients should arrive 10-15 minutes early in order to fill out appropriate paper work.

What to Bring:
  1. Insurance card with ID and group number
  2. Prescription or referral
  3. Patient’s social security number
  4. Date of Birth or that of the insurance subscriber’s (If not you)
  5. Co-pay (If applicable)
  6. If you are being treated for an auto accident or an on the job injury, please bring your prescription, your insurance company’s phone number and your claim number. We will assist you with understanding your insurance benefits for physical therapy.
  7. Written reports from diagnostic tests (If applicable).
What to Wear:
Patients should wear comfortable or loose fitted clothing during their first appointment and shorts or pants that can roll up to their knees for orthotics evaluations. If you should forget, clothing, shorts, tee shirts, and gowns are provided. There are lockers provided to safely store your belongings. Locks are available at the front desk.
What to Expect:
A full hour is reserved for your first visit. During this time a complete history is taken, an evaluation is performed, and treatment is started. We will strive to educate you about the nature of your problems, and instruct you in activities and exercises to begin at home. We take great care to make you as comfortable as possible. Please feel free to call our office with any additional questions or concerns.
Appointments & Scheduling:
The Kirkland clinic is open Monday through Friday, 6:30am to 7:00 pm.

The Bellevue clinic is open Monday through Friday 6:30 am to 7:00 pm and Saturday 8:00 am to 5:00 pm.
Same day appointments are available. If you are scheduling weekly appointments, it is advisable they not be scheduled on consecutive days.