Basis of Presentation and Summary of Significant Accounting Policies (Details) (USD $) In Thousands, unless otherwise specified	9 Months Ended	12 Months Ended
	Sep. 30, 2014	Dec. 31, 2013
Estimated allowance for appeals and estimated liability for appeals
Balance at the beginning of the period	$ 55,791	$ 34,426
Provision	14,124	41,076
Appeals found in Providers favor	(27,673)	(19,711)
Balance at the end of the period	42,242	55,791
Allowance for doubtful accounts
Balance, beginning of period	916	830
Provision	500	718
Recoveries	(17)	(42)
Charge-offs	(420)	(590)
Balance, end of period	979	916
Accounts receivable, allowance for appeals (in dollars)	$ 7,327	$ 13,939