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Revenue Recognition and Accounts Receivable Segment revenue by major payor (Tables) | 12 Months Ended
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Dec. 31, 2018
Revenues by major payor [Abstract] |
Schedule of Revenue Sources, Health Care Organization [Table Text Block] | The following table summarizes the Company's segment revenues by primary payor source:
| Year ended December 31, 2018
| U.S. dialysis and related lab services |  | Other - Ancillary services and strategic initiatives |  | Consolidated
Patient service revenues: |  |  |  |  |
Medicare and Medicare Advantage | $ | 6,063,891 |  |  | $ | — |  |  | $ | 6,063,891 |
Medicaid and Managed Medicaid | 628,766 |  |  | — |  |  | 628,766 |
Other government | 446,999 |  |  | 335,594 |  |  | 782,593 |
Commercial | 3,176,413 |  |  | 101,681 |  |  | 3,278,094 |
Other revenues: |  |  |  |  |
Medicare and Medicare Advantage | — |  |  | 492,812 |  |  | 492,812 |
Medicaid and Managed Medicaid | — |  |  | 44,246 |  |  | 44,246 |
Commercial | — |  |  | 90,890 |  |  | 90,890 |
Other(1) | 19,880 |  |  | 130,865 |  |  | 150,745 |
Eliminations of intersegment revenues | (92,950 | ) |  | (34,236 | ) |  | (127,186 | )
Total | $ | 10,242,999 |  |  | $ | 1,161,852 |  |  | $ | 11,404,851 |
(1) | Other consists of management service fees earned in the respective Company line of business as well as revenue from the Company's ancillary services and strategic initiatives.
| Year ended December 31, 2017(1)
| U.S. dialysis and related lab services |  | Other - Ancillary services and strategic initiatives |  | Consolidated
Patient service revenues: |  |  |  |  |
Medicare and Medicare Advantage | $ | 5,253,012 |  |  | $ | — |  |  | $ | 5,253,012 |
Medicaid and Managed Medicaid | 606,827 |  |  | — |  |  | 606,827 |
Other government | 362,567 |  |  | 259,651 |  |  | 622,218 |
Commercial | 3,117,920 |  |  | 63,505 |  |  | 3,181,425 |
Other revenues: |  |  |  |  |
Medicare and Medicare Advantage | — |  |  | 902,289 |  |  | 902,289 |
Medicaid and Managed Medicaid | — |  |  | 71,426 |  |  | 71,426 |
Commercial | — |  |  | 116,503 |  |  | 116,503 |
Other(2) | 19,739 |  |  | 182,974 |  |  | 202,713 |
Eliminations of intersegment revenues | (55,176 | ) |  | (24,603 | ) |  | (79,779 | )
Total | $ | 9,304,889 |  |  | $ | 1,571,745 |  |  | $ | 10,876,634 |
(1) | As noted above, prior period amounts have not been adjusted under the cumulative effect method. In this table, the Company's dialysis and related lab services revenues for the year ended December 31, 2017 has been presented net of the provision for uncollectible accounts of $485,364 to conform to the current period presentation.
(2) | Other consists of management service fees earned in the respective Company line of business as well as revenue from the Company's ancillary services and strategic initiatives.
| Year ended December 31, 2016(1)
| U.S. dialysis and related lab services |  | Other - Ancillary services and strategic initiatives |  | Consolidated
Patient service revenues: |  |  |  |  |
Medicare and Medicare Advantage | $ | 5,303,718 |  |  | $ | — |  |  | $ | 5,303,718 |
Medicaid and Managed Medicaid | 319,553 |  |  | — |  |  | 319,553 |
Other government | 143,207 |  |  | 165,193 |  |  | 308,400 |
Commercial | 3,355,066 |  |  | 36,674 |  |  | 3,391,740 |
Other revenues: |  |  |  |  |
Medicare and Medicare Advantage | — |  |  | 974,146 |  |  | 974,146 |
Medicaid and Managed Medicaid | — |  |  | 82,428 |  |  | 82,428 |
Commercial | — |  |  | 128,824 |  |  | 128,824 |
Other(2) | 16,645 |  |  | 234,107 |  |  | 250,752 |
Eliminations of intersegment revenues | (27,355 | ) |  | (24,739 | ) |  | (52,094 | )
Total | $ | 9,110,834 |  |  | $ | 1,596,633 |  |  | $ | 10,707,467 |
(1) | As noted above, prior period amounts have not been adjusted under the cumulative effect method. In this table, the Company's dialysis and related lab services revenues for the year ended December 31, 2016 has been presented net of the provision for uncollectible accounts of $431,304 to conform to the current period presentation.
(2) Other consists of management service fees earned in the respective Company line of business as well as revenue from the Company's ancillary services and strategic initiatives.

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- Definition Revenues by major payor [Abstract] + References No definition available. + Details
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- Definition Tabular disclosure of patient service revenue (net of contractual allowances and discounts), by major payor source of revenue for health care organizations. + References No definition available. + Details
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