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Samantha Collins and mom Teri share a playful moment.

FORT WORTH — For most people, the billing practices of health insurance companies are confusing, at best.

Still, a North Texas family found themselves surprised to be locked in a battle with their insurance company over a device you may think is covered under most policies.

At stake is $15,000 and a little girl's hearing.

"She is such a sweet baby," says Teri Collins of her 15-month daughter.

Little Samantha Collins has been exceptional since day one.

She was born 15 months ago with Treacher Collins, a syndrome that affects the growth of her facial bones. Her condition came as a delivery room surprise to these young parents and their doctors.

Samantha's airway is so tiny, she breathes through a tube in her neck.

"You all right?" her mom constantly asks, as her daughter wheezes. By medical standards, Samantha's Treacher Collins is considered severe.

In her case, she was also born without ears. She doesn't even have holes that would lead into the ear canal on the side of her head.

"She likes to make a lot of noise. A lot of noise," says Collins. They think little Samantha can hear those noises, but not very well.

She has a hearing aid similar to other kid's with impaired hearing.

"They would wear it right behind here and over their ear," says Collins, "which obviously we can't do. So we come up with different ways to get it on her."

Right now, the hearing aid is jury-rigged to an ordinary cotton headband that doesn't stay on an active baby's head long.

What she needs is a very special, very costly, and very permanent hearing aid - called a BAHA - a bone anchored hearing aid.

"And it's fixed straight to the bone. And it's stable. So it's not moving around," explains Medical City pediatric craniofacial specialist, Dr. David Genecov. He believes the BAHA is medically necessary for Samantha's development.

But time after time, the Collin's medical insurance company, United Healthcare, has refused to cover the $15,000 device. United HealthCare will pay for the expensive surgery to install it.

"What is most perplexing to me is the fact that the insurance company will approve the placement of the anchor and the initial operation to set the stage for the application of the hearing aid, but then they won't pay for the hearing aid," says Dr. Genecov. "That doesn't make any sense to me."

In a statement to News 8, United HealthCare explains the Collin's coverage "excludes hearing aids, including bone-anchored" ones. Many other insurance plans do the same.

United HealthCare urges all consumers to "refer to their policies" "to make sure they understand what is covered and what may not be."

The Collins never thought about coverage for hearing aids until their daughter needed one. And they're angry about a policy they say is designed to save the insurance company money. Since their daughter has no ears, they believe the BAHA would function much like a prosthesis - which is covered by their insurance policy.

"She's already going to have difficulties, I'm sorry, growing up. And, if she could get that, then maybe, maybe she could be a little more normal," pleads her mother.

Without the hearing aid, doctors say Samantha will likely never learn to speak. As it is, the only sounds she makes is the banging together of toys and some petite squeals.

"When you hear it get a little bit higher pitched, that's her laughing," says Collins. She's trying to keep the same good attitude, hoping for an insurance company's change of policy and something else extraordinary - her daughter's first word.

Health insurance companies can make exceptions.

And, companies can pay extra fees to add "riders" to a policy to pay for uncovered expenses like hearing aids and chiropractic care.

E-mail jstjames@wfaa.com.