Is Simon's Agency legit -- and how do you deal with them?

Yes -- Simon's Agency, Inc. is a legitimate, licensed collection agency, not a scam. It's based in Liverpool, New York (near Syracuse), has been around for decades, and collects across New York, New Jersey, Pennsylvania, Connecticut, and the wider Northeast. Its core is MEDICAL and healthcare collections -- hospitals, physician groups, ambulance and medical-transport, urgent care, and nursing/convalescent care -- but it also works retail, general consumer, commercial, and municipal accounts. It typically collects on behalf of the original creditor rather than as a debt buyer. The first thing to do is ask what TYPE of account it is, because that decides your leverage. If it's a medical bill, you have extra rights: demand written debt validation, ask for a fully itemized statement, and compare it against your insurance Explanation of Benefits (EOB) -- duplicate charges, un-applied coverage, and coding errors are common and disputable. Nonprofit hospitals must offer financial-assistance (charity-care) programs that can reduce or even erase part of the balance, and a surprise out-of-network bill may be limited under the federal No Surprises Act. Whatever the account type, it's a "debt collector" under the FDCPA, so you keep your validation and dispute rights: don't admit the debt on a call, dispute anything that isn't yours, and check the statute of limitations because a payment or written promise can restart the clock. One caution: a municipal or court-ordered debt (a fine, a fee) usually can't be resolved through a private debt-settlement program -- handle those directly with the town or court and ask about hardship or a payment plan. A genuinely-owed unsecured balance can often be settled in writing once it's validated; get any agreement in writing before you pay, and note that a forgiven balance over $600 can trigger a 1099-C.