Quarterly report pursuant to Section 13 or 15(d)

Revenue Recognition - Schedule of Disaggregation of Revenue (Details)

v3.19.3
Revenue Recognition - Schedule of Disaggregation of Revenue (Details) - USD ($)
$ in Thousands
3 Months Ended 9 Months Ended
Sep. 30, 2019
Sep. 30, 2018
Sep. 30, 2019
Sep. 30, 2018
Disaggregation of Revenue [Line Items]        
Total revenues $ 228,772 $ 249,815 $ 677,592 $ 768,412
Services        
Disaggregation of Revenue [Line Items]        
Total revenues 181,139 202,811 538,488 630,180
Healthcare insurers        
Disaggregation of Revenue [Line Items]        
Total revenues 104,020 123,087 315,227 382,778
Government payers        
Disaggregation of Revenue [Line Items]        
Total revenues 28,206 37,710 87,243 115,881
Client payers        
Disaggregation of Revenue [Line Items]        
Total revenues 43,750 36,837 120,309 114,666
Patients        
Disaggregation of Revenue [Line Items]        
Total revenues $ 5,163 $ 5,177 $ 15,709 $ 16,855