how is the deductble paid in health insurance? Is it tacked on to your doctors bill a little bit at a time?

I know it has to be paid b4 insurance will kick in but is it expected to be paid in a lumo sum or what. I'm trying to select insurance with a decent premium but not too high of a deductible...can someone shed some light possibly with an example?
--------------------
The deductible will be billed by your doctor's office when the insurance does not pay that bill. Each doctor's office has its own rules governing payment. Many ask that the entire amount be paid within 30 days. You can often ask for a payment schedule to stretch the payments out on a monthly basis if it is a hardship for you. Call your physician's office to ask them how they would handle this. Good luck
Source