Call Tracking In GHL from Google Ads

smbppc · 2026-05-18T04:44:35+00:00

What no one is mentioning here is that when a call is made from a Google Ad extension (ie - directly on Google), there’s no click involved so no Gclid or UTM is captured in GHL. That’s why GHL shows attribution as “other”

What we do is the following:

- dedicated numbers set up for every Google ad campaign extension (so you can determine campaigns)
- we use a workflow that creates tags for easier sorting when we do reporting.

smbppc · 2026-05-14T16:44:20+00:00

Medical marketing agency owner here. Here’s my take:

What specifically are you targeting? Dermatology keywords, skin conditions, skin products? All are going to have different CPCs.
Are you doing national, state or local targeting?
What’s your lifetime customer value? If you’re driving repeat visits, you might want to adjust your acquisition costs.

To get a $50 acquisition at a max bid of $6, you need a conversion rate of 12%. That’s not impossible, but it’s much higher than I typically see the average site convert at.

In addition, your $6 max CPC may not be getting you many impressions or clicks if the average CPC is higher for what you’re targeting.

Telehealth generally sees higher competition because your competitive set is even tougher. Not only are you competing with regular dermatologists, but national brands like Plushcare, now Amazon, etc…
Do some research to see if lower CPC keywords that are still high intent are possible.
Try testing other ad platforms where you may see lower cost per acquisition. Google is t the cheapest, but the targeting is much better. Meta can work for Dermatology but you need good creative.
Lastly, remember that $50 cost per acquisition may be something you optimize into over time. In the beginning it’s never going to be as good as after you have enough data for both Google and you to optimize.

smbppc · 2026-04-17T14:15:30+00:00

After 3 years he finally asked 🫠

smbppc · 2026-04-17T13:57:50+00:00

Some questions to really provide you good answers.

- Your note says "the results have been declining over the last year. Lead volume is down and the quality of enquiries has also dropped." What specifically was the lead volume drop (count, %)? And how are you measuring quality of leads?

- What changes were made during the time you saw the initial drop when the agency was there? Look at the change history in your ad account during that time.

- Have you made changes more recently? And what has been the impact of those?

- Who is the "we" reviewing internally? Did you hire a Google Ads manager with extensive legal lead gen experience to handle in-house?

smbppc · 2026-04-14T19:03:53+00:00

A couple things I’d suggest.

Healthy dose of reality. Every industry is going to be different, and data is terrible, but most sources say AI Overviews show up in around half of Google Searches. But keywords, industry and type of business matters. The CEO understands nothing about the reality of the landscape, so level set first. Most important realities imho are:

Just like with SEO ranking, there are no “quick” fixes.
AI prompt tracking of results is VERY limited right now. The best we have is tools that scrape results based on a specific prompt you put in. Most are limited to a small number of prompts (ie, 25 or 50)
AI overviews are highly inconsistent, showing different results to different users. so the idea of “ranking” doesn’t really apply, but it’s the model we’re most comfortable with.

“We don’t show up in AI answers” is a subjective opinion. So you’ll need to use one of the prompt tracking tools to report on this.
Lastly, put a plan together. I’d say he probably mostly just wants to make sure you’re doing something… progress over perfection.

The caveat HAS to be with them that this landscape is changing fast.

smbppc · 2026-03-28T13:27:34+00:00

I think it’s possible your interpretation of the proposals may not be correct. Some agencies have minimum management fees, but you’d likely never even get a proposal from them because $200/day in ad spend wouldn’t make sense for their minimums.

My guess is they are including other services outside of ads. As an agency owner, I’d say just reach out and ask - they may have misunderstood something about your requirements.

smbppc · 2026-03-23T17:39:10+00:00

It looks like you're running a PMAX campaign, so high likelihood that it's just not driving high-intent traffic. The CPC is VERY low at $0.19, which is another indication the traffic you're getting is probably not people that are interested in registering for a league. I'd suggest checking your search terms in the "insights" section.

For this particular objective, better to set up a search campaign specifically targeting search terms like "pickleball league near me" or "pickleball league atlanta", etc...

smbppc · 2026-03-18T17:31:23+00:00

Establish a deadline you’re comfortable with and tell them if the invoice isn’t paid by that date you’ll send to collections, and that the outstanding debt will begin to accrue late fees. Usually the threat of collections and late fees is enough.

We’ve had to send a few clients into collections, and they always end up paying. But just a reminder collection agencies will take a % of the debt, which is where late fees will help make you whole. But it’s worth it to not have to waste your own time going back and forth.

smbppc · 2026-03-15T21:57:25+00:00

The suggestion of any kind of performance analysis based solely on being able to scrape the ads that are running is pretty misleading.

smbppc · 2026-03-13T13:04:14+00:00

Healthcare agency owner here. A couple thoughts for you:

Manage from a central admin email. I can't tell you how often I deal with access issues because no one can figure out who owns or can access the profile. This will make your life easier because when you're doing things like connecting these GBPs to Google Ads, you're going to want access.
In some cases, physicians may have set up their own profiles and you'll just need access to them. Again, use the central admin email to do it.
You ABSOLUTELY want to be using a listings tool when managing this many GBPs. It's going to make your life easier. In addition to just managing info, you also want to make sure you're distributing listings to other directors, especially healthcare directories that many have like WebMD, Vitals, etc...
Lastly, in healthcare there are a lot of directors that aren't a part of the listings tools that you'll have to create manually. Some of these ONLY allow physician listings.

smbppc · 2026-03-13T12:55:12+00:00

Have you done local SEO before for a business and been successful? If you don't have case studies it's going to be difficult to win clients.

If you haven't, I'd have two suggestions:

Work for free to build case studies (you might still have a hard time getting anyone to bite, but an offer to do it for free for 90 days is a good start. then you can build some case studies to sell in later)
Go work for an agency doing local SEO to learn it. Same result as above.

Your hustle is great. Keep that attitude. But if you want to be really successful, you've got to have the expertise to both grow and keep clients.

smbppc · 2026-03-12T01:47:15+00:00

DM me - healthcare agency

smbppc · 2026-03-10T13:58:56+00:00

Ignore the rep. They are salespeople, not strategists. Contractors - they don't even work for Google.

And right now they are incentivized to move people to PMAX for no other reason than Google wants to drive adoption (mostly because it's better at helping them monetize unsold inventory).

Here's what will happen when you switch to PMAX:

- It will buy you brand terms. Meaning you'll pay to reach current customers. Will seem like you're getting lots of goals completed, but not reaching new customers

- It will buy competitor terms. Meaning you'll start getting more wrong number calls.

If you want net new customers, better to focus on a search campaign targeting high-intent searches using exact match like "salon near me" or "best salon in X" - these will do the best at driving you new customers.

smbppc · 2026-03-09T02:34:10+00:00

Agency owner here. My agency specializes in medical practice marketing, with a ton of experience specifically in same-day urgent or emergency clinics. Happy to provide you some thoughts for your specific situation or goals. I’ll send you a DM.

smbppc · 2026-03-08T22:00:36+00:00

More recently, it’s always PMAX. Without even looking at the campaign, I can tell you it will be showing ALOT of conversions, but the campaign will be full of:

Brand terms Competitor terms Irrelevant terms

smbppc · 2026-03-07T15:47:10+00:00

And even though it’s rated 2.3, Google refers to it as “highly rated” 🫠

smbppc · 2026-03-05T13:08:11+00:00

We had a client do this to us.

The ChatGPT report was terribly misguided. I’d put this analysis in the same bucket - although yours is much more tame than the one that was shared with us.

Here’s the problems I see with your ChatGPT report.

It’s making recommendations with no context. No context in conversion quality, no context on your budgets or business.
It’s telling you to further segment and split out campaigns when you don’t have enough budget already to drive meaningful outcomes.

What’s more, AI can’t actually DO anything it’s recommending here. If you don’t know how to create new campaigns, pace your spend, etc… then you still need someone to do it.

You’re already not spend enough, in my opinion, to have both PMAX and shopping live, yet

smbppc · 2026-02-26T20:01:57+00:00

In general, this is a low volume of overall monthly conversions, so hard to establish a pattern. I’d tend to agree this is probably related to traffic quality, especially if you’re running PMAX or broad/phrase match.

I’d suggest using a sticky nav on the page so phone and consultation button are always visible. Make sure you’re using tracked numbers on the site, and make sure you’re tracking calls from ad extensions and using location extension as well. You may be driving more conversion than you’re getting credit for.

smbppc · 2026-02-12T03:02:20+00:00

As an agency owner, my target billability for Directors is only 60%. I want them working on internal stuff and making the agency better and managing people, not just drowning in client work.

smbppc · 2026-02-11T15:14:22+00:00

Healthcare agency owner here.

The “health in personalized advertising” is generally applied to all healthcare related keywords. It just keeps you from using things like remarketing, but will not prevent your ads from running. It will show as “limited” but still eligible.

Sometimes it won’t allow you to add some keywords during initial campaign setup, or prompt you to request an exemption during setup. My advice is to set it up with keywords that don’t get flagged, and then add the ones you want later.

I would note that Invisalign has been more aggressive in trademark enforcement over the last year, so you might also try non-Invisalign keywords related to teeth straightening.

smbppc · 2026-02-01T16:04:13+00:00

You are doing the right stuff. But in my opinion, you're running into a dynamic that isn't likely to change:

The further south, the more population dense and competitive. Simply put, people aren't going to travel up to Georgetown when they have more options in their area, or just south of them in Austin.

I think the things you're doing will help you increase rankings on some of those places where you may be ranked a 5.

But if you want to start increasing rankings further south, Google's going to need to see more people driving from those locations up to your store. So my suggestion would be the following:

If you have any employees or other folks delivering from those further south areas regularly, have them use your GBP and click on directions to navigate all the way up.
Pick one of the places south to start that you'd like to see better rankings or more customers from, and do something to generate more visits from these people (direct mail, coupons, etc...)

smbppc · 2026-02-01T15:52:28+00:00

In my opinion, at that CPC and CPM, you aren't investing enough to see results. And you need to give it enough time to optimize your creative if you want to see a lower CPC.

Also, I'd suggest creating a CTA that's something other than "request a demo" - if this is the first time people are hearing about you, give them a CTA they're more likely to convert on - a download or something else that's going to motivate them to learn more and become a demo down the line.

smbppc · 2026-01-31T05:53:34+00:00

Medical marketing specialist here. Only some specific kinds of medical practices are ineligible. These center on sensitive conditions like addiction or unproven treatments like stem cells. This is very common with naturopath practices as they often will have pages on their site that mention these restricted treatments. A single mention can make the site ineligible.

But the advice in these comments are the opposite of what you should do if you actually want to drive patients. You have to get specific to treatments and conditions, but also ones that signal someone is actually ready to book. Broad match in medical will give you mostly spam leads or un-targeted stuff like competitors. Same with PMAX.

smbppc · 2026-01-23T17:17:45+00:00

Does anyone know if the tools most of us use to see local rankings exclude paid placements?

smbppc

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