after tire rotation and balancing, what else needs to be done?

It sounds like they will try and sell you something, the rent must be paid. You don't have to do anything but if they can show you that your brakes or tires are worn, they may suggest some other work. If so, say thanks, gotta go right now, give me a quote, and then get another check / estimate.

Alignment problems show up most often as tire wear, not pulling. If they show you excessive tire wear and suggest an alignment, they will probably want to sell you front suspension parts too. There really isn't much money in the alignment.

If they see tire wear they will be happy to point out to you the wear on the tires.They should also inspect the brakes while the wheels are off. Just ask them to check things out and let you know if any other work is needed. If they say you need brakes have them show you why. If you don't understand cars this is a learning experience for you. You might also do a search for tire wear problems and I'm certain there are photos showing the different wear patterns and their causes.

Just don't go to Jiffy Lube!! They are a big rip off and have been caught numerous times charging and not doing the work!!

This is called a "loss leader". Because they make an initial (financial) loss by giving away a service but then they convince you that your brakes need renewing and your wheels need realigning, oh and by the way your tyres are quite worn and should be renewed... need I go on ?? There is an infamous company in the UK that use this trick all the time. Avoid these companies and try to find an honest garage, possibly a friend of a friend.

If there is any unusual tire wear the car should have a four wheel alignment at the dealer of the car.

They'll probably suggest something. But you can ask for a quote and look around.

"There is no such thing as a free lunch."

if your car don't pull to one side or the other, then you are fine with not getting the alignment done.