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Organization and Description of Business - Credit Risk (Details)	3 Months Ended		9 Months Ended		12 Months Ended
	Sep. 30, 2018	Sep. 30, 2017	Sep. 30, 2018	Sep. 30, 2017	Dec. 31, 2017
Revenue | Revenue concentration risk
Concentrations of Credit Risk and Other Risks and Uncertainties
Concentrations of credit risk (as a percent)	42.00%	40.00%	40.00%	40.00%
Revenue | Revenue concentration risk | Medicare
Concentrations of Credit Risk and Other Risks and Uncertainties
Concentrations of credit risk (as a percent)	29.00%	26.00%	28.00%	26.00%
Revenue | Revenue concentration risk | UnitedHealthcare
Concentrations of Credit Risk and Other Risks and Uncertainties
Concentrations of credit risk (as a percent)	13.00%	14.00%	12.00%	14.00%
Accounts receivable | Gross receivables concentration risk | Medicare
Concentrations of Credit Risk and Other Risks and Uncertainties
Concentrations of credit risk (as a percent)			17.00%		22.00%
Accounts receivable | Gross receivables concentration risk | UnitedHealthcare
Concentrations of Credit Risk and Other Risks and Uncertainties
Concentrations of credit risk (as a percent)			11.00%		9.00%

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