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THE STATE BAR OF CALIFORNIA SPONSORED INSURANCE PROGRAMS BILLING MODE CHANGE To change your billing mode (the frequency in which you receive your premium notice), please complete this form and return

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Organizations or individuals providing services to a state agency or department and seeking reimbursement for those services.

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Agency billing - state refers to the process by which state agencies collect and manage billing for services or transactions provided to individuals or entities.

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The purpose of agency billing - state is to ensure proper financial management and accountability for state-funded services, facilitating the collection of revenues owed to the state.

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The information that must be reported on agency billing - state includes the date of service, service description, amount billed, payer information, and any relevant identification numbers.

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