What are per claim fees paid by clients to Pharmacy Benefit Managers for services like claims processing called?

Per claim fees paid by clients to Pharmacy Benefit Managers (PBMs) for services like claims processing are referred to as administrative fees. These fees cover the operational costs incurred by PBMs in managing pharmacy benefits, including processing claims, maintaining networks of pharmacies, negotiating discounts, and providing customer support. Administrative fees are integral to the overall cost structure of managing pharmacy benefits, as they ensure the continuity and effectiveness of the services provided through the PBM.

In contrast, dispensing fees are typically payments made to pharmacies for the actual dispensing of medications, while professional fees might be associated with services provided by healthcare professionals. Transaction fees might refer to costs associated with the electronic transactions of claims reimbursement but do not specifically denote the comprehensive fees associated with administrative tasks conducted by PBMs. Thus, the most fitting term in this context is administrative fees, which encompass a broad range of services beyond just the handling of claims.