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Once they turn it over to collections, only bet is to direct your concerns to the collection agency (you have more leverage).
It's sorda like the term "turnover". The original creditor feels they can't get the money, which then turnsover/sell the debt to a collection company for a lesser x amount to recoup their loss. It's harder than ever to collect debts in an economy. Some money is better than no money and lawsuit filings are time consuming and expensive to process.
It's also possible that your ins coverage may be "out of netowrk" for the ambulance fee.
You have 2 options.
1). Call the agency (collection), and try to work out a lower amount. I.e. I can only pay 45% of the amount... such and such (This will work only with collection agency). It depends on your situation. They might play hardball at first, but whatever amount your offering is better than 0 to them, so prepare to be silent and tell them this is all you can do and hang up. I'm 100% they will call back to counter or take what your offering. It has already left a blemish on your account so another few weeks to month wont make a difference.
IMPORTANT: Once a payment is decided and agreed upon, pay with a check. On the back of the check under endorsement; be sure to write PAID IN FULL and by endorsing this check you agree to delete this collection account off my report.
2). Don't pay and wait till it drops off your report.. I believe its 7 or 10 years. I would only take this option after you tried option 1.
This is all the advice I can give to you. I hope for the best an a positive outcome!
Please come back to give us an update. Good luck