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Intangible Assets, net - Amortization Expenses (Details) - USD ($) $ in Thousands | 12 Months Ended
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Dec. 31, 2018 | Dec. 31, 2017 | Dec. 31, 2016
Amortization of Deferred Charges [Abstract] |  |  |
Total amortization expenses | $ 2,777 | $ 2,654 | $ 2,367
Tradenames [Member] |  |  |
Amortization of Deferred Charges [Abstract] |  |  |
Total amortization expenses | 0 | 0 | 330
Referral Relationships [Member] |  |  |
Amortization of Deferred Charges [Abstract] |  |  |
Total amortization expenses | 2,161 | 1,934 | 1,512
Non-compete Agreements [Member] |  |  |
Amortization of Deferred Charges [Abstract] |  |  |
Total amortization expenses | $ 616 | $ 720 | $ 525

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- Definition The aggregate expense charged against earnings to allocate the cost of intangible assets (nonphysical assets not used in production) in a systematic and rational manner to the periods expected to benefit from such assets. As a noncash expense, this element is added back to net income when calculating cash provided by or used in operations using the indirect method. + References Reference 1: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 230 -SubTopic 10 -Section 45 -Paragraph 28 -Subparagraph (b) -URI http://asc.fasb.org/extlink&oid=109223946&loc=d3e3602-108585 Reference 2: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 50 -Paragraph 2 -Subparagraph (a)(2) -URI http://asc.fasb.org/extlink&oid=66006027&loc=d3e16323-109275 Reference 3: http://fasb.org/us-gaap/role/ref/legacyRef -Publisher FASB -Name Accounting Standards Codification -Topic 350 -SubTopic 30 -Section 45 -Paragraph 2 -URI http://asc.fasb.org/extlink&oid=6388964&loc=d3e16225-109274 + Details
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