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Summary of Significant Accounting Policies (Tables)

3 Months Ended

Mar. 31, 2019

Accounting Policies [Abstract]

Revision of Previously Reported Financial Information

The following tables presents the impact of the revision on the changes in the contractual allowance and allowance for doubtful accounts balances for the interim periods in the year ended December 31, 2018 (in thousands):

		Three Months Ended March 31, 2018								Six Months Ended June 30, 2018								Nine Months Ended September 30, 2018
Allowance for doubtful accounts		As reported				As revised (1)				As reported				As revised (2)				As reported				As revised (3)
Balance, beginning of period		$	3,568			$	3,568			$	3,568			$	3,568			$	3,568			$	3,568
Add: provision for doubtful accounts			1,691				325				3,822				1,791				5,917				3,254
Less: write-offs, net of recoveries and other adjustments			5				5				(2,526	)			(2,526	)			(2,514	)			(2,514	)
Balance, end of period		$	5,264			$	3,898			$	4,864			$	2,833			$	6,971			$	4,308

		Three Months Ended March 31, 2018								Six Months Ended June 30, 2018								Nine Months Ended September 30, 2018
Contractual Allowance		As reported				As revised (1)				As reported				As revised (2)				As reported				As revised (3)
Balance, beginning of period		$	7,444			$	7,444			$	7,444			$	7,444			$	7,444			$	7,444
Add: allowance for contractual adjustments			989				2,355				2,618				4,649				3,004				6,256
Less: contractual adjustments			18				18				(3,072	)			(3,072	)			(2,467	)			(3,056	)
Balance, end of period		$	8,451			$	9,817			$	6,990			$	9,021			$	7,981			$	10,644

Note that the above adjustments did not result in any changes to the Company’s total receivables-related reserves for the periods in the table above.

(1) For the three months ended March 31, 2018, the allowance for contractual adjustments was increased by $1.4 million and the provision for doubtful accounts was reduced by the same amount.

(2) For the six months ended June 30, 2018, the allowance for contractual adjustments was increased by $2.0 million and the provision for doubtful accounts was reduced by the same amount.

(3) For the nine months ended September 31, 2018, the allowance for contractual adjustments was increased by $2.7 million and the provision for doubtful accounts was reduced by the same amount. In addition, in the contractual allowances table, contractual adjustments were increased by $0.6 million and the allowance for contractual adjustments was reduced by the same amount.

Schedule of Changes in Allowance for Doubtful Accounts

The following table presents the changes in the allowance for doubtful accounts (in thousands):

		Three Months Ended March 31,				Year Ended December 31,
		2019				2018
Balance, beginning of period		$	4,851			$	3,568
Add: provision for doubtful accounts			828				5,826
Less: write-offs, net of recoveries and other adjustments			(1,346	)			(4,543	)
Balance, end of period		$	4,333			$	4,851

Schedule of Changes in Contractual Allowance

The following table presents the changes in the contractual allowance (in thousands):

		Three Months Ended March 31,				Year Ended December 31,
		2019				2018
Balance, beginning of period		$	10,601			$	7,444
Add: allowance for contractual adjustments			3,881				9,392
Less: contractual adjustments			(1,435	)			(6,235	)
Balance, end of period		$	13,047			$	10,601

Schedule of Impact of Allowance for Doubtful Accounts and Contractual Allowance on Accounts Receivable

The following table presents the impact of allowance for doubtful accounts and contractual allowance on accounts receivable (in thousands):

	Three Months Ended March 31,				Year Ended December 31,
	2019				2018
Gross accounts receivable	$	45,632			$	37,429
Less: allowance for doubtful accounts		(4,333	)			(4,851	)
Less: contractual allowance		(13,047	)			(10,601	)
Net accounts receivable	$	28,252			$	21,977

Disaggregated Revenue by Payor Type and Major Service

The Company disaggregates revenue from contracts with customers by payor type. The Company believes these categories aggregate the payor types by nature, amount, timing and uncertainty of its revenue streams. Disaggregated revenue by payor type and major service line for the three months ended March 31, 2019 was as follows (in thousands):

		Three Months Ended March 31,
		2019				2018
Commercial Payors		$	24,347			$	13,491
Centers for Medicare & Medicaid			12,746				8,432
Healthcare Institutions			10,121				8,642
Total		$	47,214			$	30,565

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