how to approach this medical bill in collections?

[remethy]

Once it has aged off my credit report, what happens if I then pay it (or make payments toward it)?  Does that allow it to be put back on the report?  I would be willing to try to make the debt right - but not if it's going to hurt my credit.

[guiness56]

No, it can't be put back on your report.  Making payments could restart the SOL for suing depending on your state laws.