A payment system for spending accounts is provided. The payment system includes a qualified vendor system, such as a point of sale system at a doctor's office, that generates purchase data and point of sale data, such as a co-pay amount, a credit card number, and a point of sale device identifier. An account management system receives the purchase data and point of sale data and generates authorized purchase data, such as by determining whether payment of co-pay can be automatically authorized based on pre-qualification of the doctor's office as an authorized source.