Let me explain a little more. I was the victim of a car accident and medical bills went through the roof. I had about $16k racked up, then my settlement finally kicked in 3 years later and paid it all off (except for that pesky $8). What happened was when we queried the debt from the hospital I went to, they somehow missed that $8 (out of the $16k) and sent it to collections. This all happened about 4 years ago. I didn't receive any letters in the mail for some reason as well. I did a credit check a few months ago to get a car loan, and my banker found the collection. I need to get rid of it, because a job I want to apply for also looks at my credit. 

Should I pay it off?  

I would not like it to be on my credit history...  

Can I dispute it since they failed to bill me for it in the first place?