One or more servers (70) are configured to periodically format (90, 92) and send (94) payments (26) to a payee in an order of preference (62) and a specified payment method until accepted (96). The payments (26) include a consolidated financial instrument (73) and at least one explanation of explanation of benefit (75) associated with the consolidated financial instrument. The consolidated financial instrument (73) transfers accumulated monies without co-mingling funds in compliance with ERISA regulations. The at least one associated explanation of benefit (75) includes a patient identification, a payer identification, a service provider identification, a date of service, a service identification, a patient obligation, and an amount paid. Acceptance of the payment to each payee is recorded (100) in a data store (102).