Paid search

Google Ads without the OCR letter.

Most agencies run healthcare ads with the same tracking stack they use for e-commerce. That’s how BetterHelp and GoodRx ended up on the FTC’s front page. We run paid search with Restricted Data Processing, server-side GA4, Consent Mode v2, and BAA-covered call tracking, built for practices that can’t afford to be the next case study.

The problem

Your current agency is probably a liability.

Since the December 2022 HHS bulletin on tracking technologies, most healthcare paid-search setups have been quietly out of compliance. The Meta Pixel on the “Book An Appointment” page. The client-side GA4 tag pulling URL paths that reference procedures. The call-tracking provider with no BAA.

These are not theoretical concerns. FTC fines against BetterHelp ($7.8M), GoodRx ($1.5M), and Premom ($100K) all centered on the same pattern: patient data leaving the practice via ad pixels and analytics tools the practice never realized were PHI-exposed.

Most practices still have these

  • Meta Pixel fired on intake and appointment-confirmation pages
  • Client-side GA4 collecting URL paths that reference procedures
  • Call tracking without a signed BAA
  • Enhanced conversions sending unhashed email from the portal
  • Third-party chat widget with no BAA on transcripts
How we run it

Signal to Google. No PHI out the door.

Google still gets enough signal to optimize your campaigns, because we send hashed, server-derived conversion data off the authenticated session. Your patient data never touches an ad network's servers.

  • Restricted Data Processing on the Google Ads account
  • Server-side GA4 with a first-party sGTM container
  • Consent Mode v2 wired for Google + Bing
  • Enhanced conversions with server-computed SHA-256 hashing
  • Call tracking under BAA (CallRail or CTM)
What we do

Full-service paid search for healthcare.

Google & Bing Search Ads

Campaigns built around real patient intent, “Mohs surgeon near me,” “same-day ortho consult [city],” payer-specific queries. Ad copy reviewed against LegitScript and FTC health-advertising guidance.

Catchment geo-targeting

Targeting tuned to drive-time isochrones, not arbitrary mile radii. Overlay payer-mix data so you don’t spend on ZIPs whose insurance your practice doesn’t accept.

Compliant landing pages

Fast, accessible, WCAG 2.2 AA. Forms collect contact info only, clinical intake stays inside your patient portal or EHR. Zero third-party tags firing on the confirmation page.

Bid strategy tuned to LTV

Bid modifiers weighted to long-term patient value, not just first-visit revenue. A recurring dermatology patient is worth eight times a one-visit consult. Your bids reflect that.

BAA-covered call tracking

CallRail or CallTrackingMetrics under a signed BAA. Recordings encrypted at rest, redacted as needed, retained per your practice’s policy, not the vendor’s default.

Attribution to the PMS

Conversions reconciled to actual scheduled appointments in your practice management system via a BAA-covered pipe. Google Ads learns from appointments, not form fills.

Technical details

The stack we actually put in production.

Server-side Google Tag Manager

A first-party sGTM container on your subdomain. Client-side tags send to us, we decide what, if anything, gets forwarded to ad networks. PHI is stripped before anything leaves your perimeter.

Consent Mode v2

Default-denied consent state on any page a patient might reach. Ad-storage and analytics-storage only flip to granted after an explicit interaction. Enhanced conversions run in ad_user_data: denied by default.

Restricted Data Processing

Google Ads account flag enabling limited data processing for California users (and now voluntarily applied across the account) to reduce the surface area Google can use your conversion data for.

Enhanced conversions: hashed

Conversions fire from the server with SHA-256-hashed email and phone computed off the authenticated session. Google gets a hashed identifier for matching. Your patient record never leaves the practice.

Typical campaign structure

Built for specialties

  • High-intent branded"[practice name]", "[provider name] MD"
  • Near-me core"[specialty] near me", "[specialty] [city]"
  • Procedure-specific"[procedure] cost", "[procedure] consultation"
  • Payer-tied"[payer] [specialty]", "in-network [specialty] [city]"
  • Condition research"[condition] specialist", "second opinion [condition]"
  • Competitive conquestCompetitor names + “alternatives” / “vs.”
Our commitment

Your dedicated paid-search team.

Paid search for a HIPAA-covered practice requires a strategist, a compliance-aware analyst, and an editor who can read FTC guidance. You get all three.

Dedicated strategist

A paid-search strategist with healthcare vertical experience. They read the OCR bulletins so you don’t.

Same-day response

Questions get a business-day answer. Compliance escalations get a same-hour answer. Not via a ticket queue.

BAA first

Every tool we introduce carries a BAA, signed before it goes live. Your counsel sees the stack before we do.

No lock-in

Month-to-month. If we can’t demonstrate compliant growth, you leave. That keeps us honest.

Getting started

From audit to live.

  1. 01

    Compliance audit

    Tag inventory across your marketing site and patient portal. Risk-ranked remediation plan delivered in writing.

  2. 02

    Infrastructure

    Server-side GTM container, BAA-covered call tracking, and RDP enabled before any campaign launches.

  3. 03

    Campaign build

    Specialty-specific campaign structure, PMS-tied conversion goals, and landing pages reviewed by your clinical lead.

  4. 04

    Optimize and scale

    Daily bid management, weekly reporting against PMS appointments, monthly strategy call with the full account team.

FAQ

Questions practices ask

Do you run Google Ads with Restricted Data Processing?

Yes. Paid search on Google and Bing runs with Restricted Data Processing and BAA-covered call tracking. Catchment bidding skips ZIPs the payer mix will not cover.

Where does GA4 run, and how does Consent Mode work?

Consent Mode v2 and server-side GA4, through a first-party server-side container. Hashed enhanced conversions are computed off the authenticated session. Consent is default-denied on any page a patient might reach. Ad storage and analytics storage flip to granted only after an explicit interaction.

Do you put the Meta Pixel on booking or portal pages?

Per HHS's December 2022 and March 2024 OCR bulletins, Meta Pixel and client-side GA never load behind the patient-portal login. The paid-search page lists a Meta Pixel on intake and appointment-confirmation pages, and client-side GA4 collecting URL paths that reference procedures, among the setups most practices still have.

Is call tracking under a BAA?

Yes. Call tracking is under a signed BAA. On paid search, that is CallRail or CallTrackingMetrics. Recordings are encrypted at rest, redacted as needed, and retained per the practice’s policy rather than the vendor’s default.

Who signs the other BAAs?

Call tracking, CRM, hosting, email, and the analytics forwarder are tools that could touch PHI. Each one executes a BAA before we turn it on. Counsel gets the stack on day one.

Who is a fit, and can we leave?

We work with HIPAA-covered practices doing $1M+ in annual revenue. One practice per specialty per metro. If we work with your competitor, we won't work with you, and the reverse is true. The engagement is month-to-month. We earn the work every 30 days.

Written report

Audit your current stack.

We’ll inventory every tag on your site and portal, map each one to current OCR guidance, and deliver a written risk assessment, whether you hire us or not. Written report. No sales call required to receive it.

Request a compliance audit