<human>: Around March of last year, I brought a close friend to an ER in Southern California for symptoms that made me think she was having a stroke (It wasn't a stroke, but it was much worse).  
She didn't have insurance and was afraid to go, but I told her I'd help her handle it.  
Long story short, she was kicked out of her house shortly after by her Uncle, who didn't give us her mail for months. By the time we got a hold of them, we saw that her medical bill was already turned into collections, so we haven't done anything about it until now.
  
**I know I messed up as a friend saying I'd handle it, then didn't even man-up enough to get her mail from the Uncle earlier, so I'm trying to fix it now.*

Because we barely have money, we have just now saved enough to potentially pay off the whole debt, but I know that that's going to result in worsening her credit score and that a pay-to-delete would be preferable.

So before looking for how to get a pay-to-delete, we looked up her credit reports last week.  
Surprisingly, her medical bill didn't show up in them, so they were positive reports.  
She even applied for her first credit card a month ago with her bank to see if her debt was affecting her credit, and she was actually approved.

**My question is:** What does this mean? Do bills in collections take more than a year to show up on credit reports?  
If it's not showing up, can we ignore it, or should we at least send the collections agency a certified-mail letter asking for a pay-to-delete, just in case it shows up on her reports in the future?

Summarize the given text in a few sentences.
<bot>: Friend has a 1-yr old medical bill in collections that isn't showing up on her credit reports. She even got approved for her first credit card last month. What does this mean, and what should we do?