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You pay, then you are paid back
A French doctor's visit works differently from an American one. You see the doctor, you pay at the end — a consultation with a generalist is set at a fixed and modest rate — and the reimbursement comes back to your bank account automatically, usually within days, through the carte Vitale you hand over at the desk. Most of it is covered by the state scheme and the remainder by a mutuelle, the top-up insurance most people carry. Declaring a médecin traitant, a regular doctor, keeps the reimbursement rate high; going elsewhere without one lowers it.