What other industry can afford to mail out a 4-page hardcopy bill for $0?

Blue Cross sent us a 4-page hardcopy document in the U.S. mail last week.

This document is the result of a routine vaccination visit for our 5-month-old. Presumably part of the reason that this isn’t sent via email is concern about privacy, though “preventive medicine” and “other med services” aren’t very revealing.

If we could have paid cash for these services at a competitive rate they presumably would have cost no more than the $362 that Blue Cross actually paid. Is there any other industry that can afford to have these back-end tails of paperwork following a $362 purchase?

Related: this May 2010 posting about a $15 hardcopy bill following an $83 annual checkup.


  1. George

    May 19, 2014 @ 1:07 pm


    I once got a $0.15 bill on a 2 page hard-copy paper. I was debating how to pay it:

    1) via mail it would have cost me an extra $0.38,
    2) via phone, it would have cost me wait time on the phone and the lab would lost % for the translation, or
    3) via in person visit, it would have cost me the trip and I would have added to carbon footprint.

    I decided not to pay it and for the next 3 months I keep on getting the bill then I figured I better pay it otherwise they would send it to a collection agent.

    As you know, this whole thing is automated and I guess it keeps the “ecosystem” well oiled: postal service, office supply, services, etc.

  2. jay c

    May 19, 2014 @ 6:56 pm


    Financial. I participate in the ESPP at my office. I don’t sell the ESPP right away for tax reasons. I get 2 statements per year informing me of my ESPP purchase, 4 statements per year informing me of dividends I received. When I sell last year’s stock, I get another statement, and in the beginning of the year I get the 1099 for the past year. So I get 8 statements per year which costs them over $2 in postage + paper costs. I can’t figure how to turn off receiving paper statements on the website of the august financial institution i.e., too big to jail/fail bailout honoree.

  3. Norman Yarvin

    May 20, 2014 @ 12:35 am


    Sometimes they send out this sort of stuff to prevent provider fraud, where you never visit the doctor but he bills the insurance company anyway, or where you did visit but he bills for more services than you received. The idea is that you’ll notice the discrepancy and complain. It can also catch fraud by people who forge insurance cards to visit a doctor. Suppressing fraud can be quite cost-effective, even when it seems (to honest people) like a complete waste.

  4. Isaac D.

    May 20, 2014 @ 12:57 pm


    Second vote here for financial. I had a 401k account from an old job that I had rolled over, but apparently due to a rounding error on their end, the rollover was incomplete and left a couple of pennies in the account. For a few years, they would mail me quarterly statements indicating my balance of roughly 2 cents until I eventually got someone on the phone to mail me a check for $0.02 and close the account for good.

  5. John O

    May 21, 2014 @ 1:39 pm


    I once worked in the mail room for a company that processed and mailed bills (lenders in the sub-prime auto loan industry outsourced the work to my company). Obviously, there is not a person stuffing that bill into an envelope, but a machine. And once stuffed into the envelope, the bills are sorted by zip code (ours was outsourced to yet another company called Pre-Sort). The postage was a fraction of first class mail, because much of the USPS’s work was done for them at our end (the zip code sorting). The marginal cost for one additional bill (regardless of the amount) was pretty close to zero.

    This was an old legacy system and we did not have a customer interface that allowed customization of billing preferences. But I would imagine insurance companies still send a bill to each customer today because it’s the way they’ve always done it.

  6. Mark Lutton

    May 22, 2014 @ 1:05 am


    It’s not really a bill. It’s a combination of an information report (probably required by law to notify you of disbursements on your behalf by the insurance company) and a bill, or it would be if you owed any money on the bill. So it’s just an informational report (probably required by law).

    My insurance company sends the information report separately from the bill. The information report says in big letters “THIS IS NOT A BILL.”

  7. J. Den

    May 22, 2014 @ 11:09 am


    A friend once gave my kids a share of stock as a birthday present. It carries a dividend of 15 cents or so. They mail a check every quarter. I think some smarter corporations have a stock buy back program where they offer to buy out small shareholders at above market rates just to get rid of them.

    Blue Cross may have its reasons (as some of the other commenters indicated) but in general you would think that it would only take a few lines of code to filter out bills where the face amount of the bill is less than the cost of postage. A business could even use this as a selling point.

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