Revenue Recognition Revenue Recognition

3 Months Ended

Mar. 31, 2020

Revenue recognition

The following table summarizes the Company's segment revenues by primary payor source:



	For the three months ended
	March 31, 2020									March 31, 2019
	U.S. dialysis			Other - Ancillary services			Consolidated			U.S. dialysis			Other - Ancillary services			Consolidated
Dialysis patient service revenues:
Medicare and Medicare Advantage	$	1,502,222		$			$	1,502,222		$	1,493,516		$			$	1,493,516
Medicaid and Managed Medicaid	171,467						171,467			154,190						154,190
Other government	111,910			94,574			206,484			106,127			84,475			190,602
Commercial	825,582			39,467			865,049			788,413			33,388			821,801
Other revenues:
Medicare and Medicare Advantage				98,478			98,478						61,700			61,700
Medicaid and Managed Medicaid				366			366						6			6
Commercial				10,521			10,521						32,619			32,619
Other⁽¹⁾	5,442			17,602			23,044			4,905			17,750			22,655
Eliminations of intersegment revenues	(32,242		)	(4,152		)	(36,394		)	(30,641		)	(3,336		)	(33,977		)
Total	$	2,584,381		$	256,856		$	2,841,237		$	2,516,510		$	226,602		$	2,743,112


(1)	Other consists of management service fees earned in the respective Company line of business as well as other revenue from the Company's ancillary services.

The Company’s allowance for doubtful accounts related to performance obligations satisfied in years prior to January 1, 2018 was $4,422 and $8,328 as of March 31, 2020 and December 31, 2019, respectively.

There are significant uncertainties associated with estimating revenue, which generally take several years to resolve. These estimates are subject to ongoing insurance coverage changes, geographic coverage differences, differing interpretations of contract coverage and other payor issues, as well as patient issues including, without limitation, determination of applicable primary and secondary coverage, changes in patient insurance coverage and coordination of benefits. As these estimates are refined over time, both positive and negative adjustments to revenue are recognized in the current period.

Dialysis patient service revenues. Revenues are recognized based on the Company’s estimate of the transaction price the Company expects to collect as a result of satisfying its performance obligations. Dialysis patient service revenues are recognized in the period services are provided based on these estimates. Revenues consist primarily of payments from government and commercial health plans for dialysis services provided to patients. A usual and customary fee schedule is maintained for the Company’s dialysis treatments and related lab services; however, actual collectible revenue is normally recognized at a discount from the fee schedule.

Other revenues. Other revenues consist of fees for management and administrative support services provided to outpatient dialysis centers that the Company does not own or in which the Company owns a noncontrolling interest, revenues associated with the Company's non-dialysis ancillary services, and administrative and management support services to certain non-dialysis joint ventures in which the Company owns a noncontrolling interest.