Want us to submit insurance claims on your behalf?

Check your benefits here. If your insurance plan allows for out-of-network reimbursement, we will send all the necessary information to your insurance company so that you can get reimbursed or have the session fee apply to your deductible.

Fill out the info below and we'll get the ball rolling. If we run into any issues, we'll reach out to you directly. Don't hesitate to reach out to [email protected] with any questions.

Primary Insurance Policy Holder *

Last Name on your insurance card *

First Name on your insurance card *

Your name, if different than insurance holder:

Your email *

Who is your provider at Rouse? *

Your phone *

Full name of your insurance provider *

Member ID (Include all prefixes) *

Group ID on card

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