I got a "final notice" debt collection letter. Can you help me understand what it means?

Your best chance might be contacting them and explain your situation there might be a payment plan they can do if they know your not disputing the bill and want to pay

Collection agencies are powerless. Dispute thr debt ( yiu don’t have to explain why) and they have to stop collecting until you agree to the debt.

States differ. Here they can't take your car. Probably the first of an endless stream of final notices. It will hurt your credit rating. Tell them you will pay it next month, whether you do or not.

they can yell and bully

but bottom line is they can't do anything unless and untill they
sue you
get a judgement
and then deposition you to get a list of assets

they COULD take your car (assuming there is no lien on it)
and then sell it at auction

BUT

the reality is that all of that would cost much much more than the 124 bucks so the aren't going to do it.

what you can do is
demand that they cease all phone call immediately and put all future communication in writing

follow up this demand with an email to them so you can prove you demanded no phone calls.

calling you after that is a violation of federal consumer laws and I suspect new york's is even tougher.

you can also demand that they produce proof of the debt - that normally freaks them out.

Debt collectors are just licenced thugs for hire. Fuck them. I’ve got them chasing me even I was a victim of fraud (by a mate soon to be a victim of my vengeful rage). I tell those debt collectors to eat a dick and choke.

I wouldn't be that surprised if the "final notice" wasn't also the first notice as well. If the notice is from the hospital itself rather than a collection agency that sounds about right.

Don’t talk to a collection agency. You don’t owe thrm an explanation. They are powerless. Like the big bad wolf. It will leave you stressed and upset. Block them

How much is the debt?