Revenue Recognition and Contractual Adjustments - Adjustment of Transactions Revenue (Detail) (USD $) In Thousands, unless otherwise specified	3 Months Ended	9 Months Ended
Sep. 30, 2014	Sep. 30, 2013	Sep. 30, 2014	Sep. 30, 2013
Revenue Recognition [Abstract]
Gross Service Revenues	$ 60,660	$ 45,159	$ 159,665	$ 129,625
Total Contractual Adjustments and Discounts	(37,443)	(28,275)	(97,595)	(81,481)
Net Revenues	$ 23,217	$ 16,884	$ 62,070	$ 48,144

Aggregate revenue during the period for services rendered in the normal course of business (before deducting allowances and discounts) which are not otherwise defined in the taxonomy.

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 225

-SubTopic 10

-Section S99

-Paragraph 2

-Subparagraph (SX 210.5-03.1(d))

-URI http://asc.fasb.org/extlink&oid=26872669&loc=d3e20235-122688

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 03

-Paragraph 1

-Article 5

Name:	us-gaap_SalesRevenueServicesGross
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	duration