Method and system for processing transactions involving accounts for reimbursing medical expenses or patient responsible balances with multiple transaction substantiation modes

A computer implemented method for processing transactions involving accounts for reimbursing qualified medical expenses and/or patient responsible balances (PRBs), comprising:

• receiving enrollment data of participants electing to perform payment-card transactions using accounts for reimbursing qualified medical expenses and/or PRBs;
• assigning a first status to a first participant;
• assigning a second status to a second participant, wherein the first status and second status cause different types of substantiation;
• receiving from a first goods or service provider a request to authorize payment of a qualified medical expense and/or PRB against an account associated with a first participant in connection with a first sales transaction between the first participant and the first goods or service provider;
• receiving from a second goods or service provider a request to authorize payment of a qualified medical expense and/or PRB against an account associated with a second participant in connection with a second sales transaction between the second participant and the second goods or service provider;
• in response to the participant's assigned status being of the first status, electronically performing a real-time substantiation of the first sales transaction using a computerized system, providing authorization of payment of the qualified medical expense and/or PRB against the associated account, and communicating to the goods or service provider authorization of payment of the qualified medical expense and/or PRB against the associated account, wherein the communicating the authorization occurs subsequently to the real-time substantiation;
• and
• in response to the second participant's assigned second status, electronically performing a second substantiation of the second sales transaction using a computerized system, the second substantiation being a retrospective substantiation of the second sales transaction, and communicating to the second goods or service provider authorization of payment of the qualified medical expense and/or PRB against the account associated with the second participant, wherein the retrospective substantiation is performed subsequently to the communication of the authorization.