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Accrued Professional Liability: | 12 Months Ended
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Dec. 31, 2012
Accrued Professional Liability: | 9. Accrued Professional Liability: At December 31, 2012 and 2011, the Company’s total accrued professional liability of $137.0 million and $122.8 million, respectively, includes incurred but not reported loss reserves of $90.6 million and $79.5 million, respectively, and loss reserves for reported claims associated with self-insured retention amounts through the Company’s wholly owned captive insurance subsidiary of $46.4 million and $43.3 million, respectively. The activity related to the Company’s total accrued professional liability for the years ended December 31, 2012, 2011 and 2010 is as follows (in thousands):
|  | Years Ended December 31, |
|  | 2012 |  |  | 2011 |  |  | 2010 |
Balance at beginning of year |  | $ | 122,847 |  |  | $ | 111,662 |  |  | $ | 109,628 |
Provision (adjustment) for losses related to: |  |  |  |  |  |  |  |  |  |  |  |
Current year |  |  | 35,441 |  |  |  | 33,031 |  |  |  | 27,086 |
Prior years |  |  | (8,119 | ) |  |  | (10,099 | ) |  |  | (11,142 | )
Total provision for losses |  |  | 27,322 |  |  |  | 22,932 |  |  |  | 15,944 |
Claim payments related to: |  |  |  |  |  |  |  |  |  |  |  |
Current year |  |  | (569 | ) |  |  | (221 | ) |  |  | (553 | )
Prior years |  |  | (12,564 | ) |  |  | (11,526 | ) |  |  | (13,357 | )
Total payments |  |  | (13,133 | ) |  |  | (11,747 | ) |  |  | (13,910 | )
Balance at end of year |  | $ | 137,036 |  |  | $ | 122,847 |  |  | $ | 111,662 |
The net increases in the Company’s total accrued professional liability for the years ended December 31, 2012 and 2011, are primarily attributable to increases in the current year provision for losses as a result of the increase in the number of physicians insured due to acquisitions and internal growth, offset by claim payments and adjustments to the provision for losses related to prior years resulting from favorable trends in the Company’s claims experience.

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- Definition The entire disclosure for the accrual for malpractice loss contingencies (general and professional liability) which may include the policy used for accruing the loss contingency, the nature and amount of any accrual, and any significant estimate used to determine the accrual. + References Reference 1: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 3 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14394-108349 Reference 2: http://www.xbrl.org/2003/role/presentationRef -Publisher AICPA -Name Audit and Accounting Guide (AAG) -Number AAG-HCO -Paragraph 12 -IssueDate 2006-05-01 -Chapter 8 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 3: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Statement of Financial Accounting Standard (FAS) -Number 5 -Paragraph 9, 10, 11 -LegacyDoc This reference is SUPERSEDED by the Accounting Standards Codification effective for interim and annual periods ending after September 15, 2009. This reference is included to help users transition from the previous accounting hierarchy and will be removed from future versions of this taxonomy. Reference 4: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 10 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14615-108349 Reference 5: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 450 -Section 50 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=6491354&loc=d3e6052-115624 Reference 6: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 9 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14557-108349 Reference 7: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14326-108349 Reference 8: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 6 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14472-108349 Reference 9: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 4 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14435-108349 Reference 10: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 954 -SubTopic 450 -Section 50 -Paragraph 1 -URI http://asc.fasb.org/extlink&oid=6491354&loc=d3e6049-115624 Reference 11: http://www.xbrl.org/2003/role/presentationRef -Publisher FASB -Name Accounting Standards Codification -Topic 450 -SubTopic 20 -Section 50 -Paragraph 5 -URI http://asc.fasb.org/extlink&oid=6952336&loc=d3e14453-108349 + Details
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