Sounds about right for many offices. A good billing and coding person is an invaluable tool for a physician. In the practice where I recently worked, we collected and verified insurance information prior to any patient showing up, which meant that we knew how much of their deductible was left, what their coinsurance and copays were, etc. No patient scheduled an appointment until this information was in our system, and every patient got an e-mail or a letter with how much they would owe when they walked in the door (be it $20 or $749.89).
A large number of doctors are not very good at the whole business side of things, and it leads to experiences like this patient's. My internist wouldn't give me a physical in June 2011 because I had one in July 2010. I explained that I had called my insurance company and they assured me that I had a calendar-year policy and could get 1 physical a year. They wanted me to pay $650 up front. I had the insurance company call them. That put the issue to rest and they were reimbursed $189.