Summary of Significant Accounting Policies (Details) (USD $)	Sep. 30, 2012	Dec. 31, 2011
Accounts receivable are reported net of allowances for contractual adjustments and doubtful accounts
Allowance for contractual adjustments	$ 1,680,078	$ 1,563,324
Allowance for doubtful accounts	1,480,663	1,537,288
Total	$ 3,160,741	$ 3,100,612

For an unclassified balance sheet, a valuation allowance for receivables due a company that are expected to be uncollectible.

Reference 1: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 310

-SubTopic 10

-Section 50

-Paragraph 4

-URI http://asc.fasb.org/extlink&oid=7512638&loc=d3e5074-111524

Reference 2: http://www.xbrl.org/2003/role/presentationRef

-Publisher SEC

-Name Regulation S-X (SX)

-Number 210

-Section 02

-Paragraph 4

-Article 5

Reference 3: http://www.xbrl.org/2003/role/presentationRef

-Publisher FASB

-Name Accounting Standards Codification

-Topic 942

-SubTopic 210

-Section S99

-Paragraph 1

-Subparagraph (SX 210.9-03.10)

-URI http://asc.fasb.org/extlink&oid=6876686&loc=d3e534808-122878

Name:	us-gaap_AllowanceForDoubtfulAccountsReceivable
Namespace Prefix:	us-gaap_
Data Type:	xbrli:monetaryItemType
Balance Type:	credit
Period Type:	instant