Abstract: Techniques are disclosed for allowing a heath care provider to receive payment from a customer's pre-funded account in exchange for health services provided to a customer, through the use of a healthcare card. The card is issued to the customer by a health plan organization and is linked to a pre-funded account for that customer. The health care provider is under contract with the organization to offer a pre-determined fee structure for covered services. Customers can obtain contracted rates for services via the card, regardless of any limitations that might apply under a health insurance policy or other program. Online, real-time methods are disclosed for the substantiation of payment claims to ensure they are within governmental guidelines for FSA/HRA/HSA coverage. Additional aspects are disclosed whereby health care providers can choose to be paid directly from a health plan organization via an electronic funds transfer into the provider's bank account.