CONDENSED CONSOLIDATED STATEMENTS OF CASH FLOWS - USD ($) $ in Thousands	6 Months Ended
	Jun. 30, 2015	Jun. 30, 2014
Operating activities:
Net income	$ 8,940	$ 9,391
Adjustments to reconcile net income to net cash provided by operating activities:
Depreciation and amortization of property and equipment	16,002	16,253
Amortization of intangible assets	10,154	10,293
Amortization of deferred financing costs	1,042	1,042
Stock-based compensation expense	7,068	6,230
Excess tax benefit from exercised stock options	(1,456)	(854)
Deferred income taxes	(3,483)	(3,996)
Allowance for doubtful accounts and bad debt write-offs	1,549	(6,462)
Loss on disposal of fixed assets	10	4
Change in fair value of contingent consideration		11
Changes in operating assets and liabilities
Accounts receivable	(15,844)	(5,050)
Prepaid expenses	628	2,032
Prepaid income taxes	6,265	7,311
Other current assets	5	19
Other assets	(660)	(45)
Accounts payable, accrued expenses and other liabilities	(11,479)	(1,193)
Estimated liability for appeals	1,349	12,563
Net cash provided by operating activities	20,090	47,549
Investing activities:
Purchases of land, property and equipment	(5,022)	(10,315)
Investment in capitalized software	(1,340)	(1,309)
Net cash used in investing activities	(6,362)	(11,624)
Financing activities:
Repayment of revolving credit facility		(35,000)
Proceeds from exercise of stock options	3,412	3,076
Excess tax benefit from exercised stock options	1,456	854
Payments of tax withholdings on behalf of employees for net-share settlement for restricted stock awards and units	(628)	(1,088)
Payments on capital lease obligations	(655)	(826)
Payments on contingent consideration		(428)
Net cash provided by (used in) financing activities	3,585	(33,412)
Net increase in cash and cash equivalents	17,313	2,513
Cash and cash equivalents at beginning of period	133,116	93,366
Cash and cash equivalents at end of period	150,429	95,879
Supplemental disclosure of cash flow information:
Cash paid for income taxes	8,226	3,503
Cash paid for interest	3,868	2,538
Supplemental disclosure of noncash activities:
Accrued property and equipment purchases	154	1,633
Equipment purchased through capital leases		20
Decrease in appeals liability for lost appeals offset with a reduction in accounts receivable	$ 4,134	$ 18,695