medical debt settle or not to settle?

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I have been working on my credit since this past February. I pulled my credit report again in may I noticed a collection account from a hospital. I never received the initial bill. I called the hospital they told me to contact the debt collector. I called to request an itemized statement. My question is should I settle this as I am in the process of cleaning up a few things before applying for a mortgage. I curious if this stays on as an open collection will it affect the debt to income ratio. I am debt free but this is the only thing dragging down my report. Any advice would be appreciated. I would also like to thank everyone on this site. It has helped me tremendously.

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It will report as a close/settled account.  So no to the debt/income ratio.  It depends on how old the account is as to how it will affect your score, It shouldn't bring it down if they are already reporting an open collections account.

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