She wanted to know if is advisable to contact the medical billing company directly after it has gotten to this point.
To answer her question about that past-due medical bill, yes, I would suggest that you contact the medical billing company (or your health care provider) first.
They may be willing to work out a deal with you, particularly to allow you to pay a lower amount than the debt collection agency.
Needless to say that $150 so-called “processing fee” is just the debt collection firm’s way of trying to make some extra money off of you.
If you can’t pay what you owe in full to the medical company, then request a reasonable payment plan, perhaps of 6 months or so (depending on what you can afford).
If they balk, and say “No, you must speak to the debt collector”, then do contact the collection agency and start negotiating.
Try to take a hard stance, and refuse to pay that extra $150 bill. Say “I can agree to pay what I originally owed, but I’m not willing or able to pay an extra $150 in miscellaneous fees.”