Basis of Presentation (Details) (USD $) In Thousands, unless otherwise specified	6 Months Ended	12 Months Ended
	Jun. 30, 2014	Dec. 31, 2013
Basis of Presentation
Estimated liability for appeals	$ 35,720	$ 41,852
Allowance for doubtful accounts
Balance, beginning of period	916	830
Provision	(500)	(718)
Recoveries	(17)	(42)
Charge-offs	(167)	(590)
Balance, end of period	1,232	916
Estimated allowance for appeals and estimated liability for appeals
Balance at the beginning of the period	55,791	34,426
Provision	12,166	41,076
Appeals found in Providers favor	(25,076)	(19,711)
Balance at the end of the period	42,881	55,791
Accounts receivable, allowance for appeals (in dollars)	$ 7,161	$ 13,939