Fill out our insurance verification form below
Apply & Verify Insurance
Application and verification for our intensive residential alcohol and drug addiction treatment program is quite simple. Fill out the form below and the information you provide is confidential and secure. This submission will help us make the best treatment recommendations possible. There is no obligation/commitment after submission. You can expect follow-up within 24-48 hours.
In order for us to provide you with information about your behavioral health benefits, the starred (*) fields must be completed.
If you are insured by United Health or Optum, a reference number is needed to verify benefits from these companies. Please call your provider, authorize the Rose House to verify those benefits, and they will provide a reference number to share with us. Please list that reference number in the comments section below.
(?) On your insurance card it may say "for providers call" or "for behavioral health call".