Google Ads management for high-intent leads at a known cost
We build and run Search, Performance Max, Local Services and remarketing campaigns in your own account. Tracking counts calls, forms and booked appointments, search terms get reviewed every week, and your report shows what each qualified lead cost.
- 7+Years of experience
- 1,000+Projects delivered
- 9Industries served
Campaign types
The right Google Ads campaigns for your kind of business
Google offers more campaign types than most businesses need. Pick your business model to see which we'd start with, which we'd add later, and which we'd skip.
One location, patients or customers from a set area.
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Start here
Search
Text ads on Google when people search for what you offer.
Most people search before they call. That's where the intent is.
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Add later
Performance Max
One campaign across Search, Maps, YouTube, Display and Gmail, run by Google's AI.
Once tracking has a few weeks of real conversions, it can add Maps and YouTube reach.
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Start here
Local Services Ads
Pay-per-lead ads with a Google verification badge, for eligible local categories.
Where Google offers it for your category, you pay per lead and often appear at the very top.
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Limited
Remarketing and Display
Ads shown to people who visited your site, across websites and apps.
Health services can't use remarketing lists. Fine for other local services.
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Skip
Demand Gen and YouTube
Image and video ads on YouTube, Discover and Gmail that build demand.
Rarely the best first spend for a single location.
Several sites, each with its own demand and capacity.
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Start here
Search
Text ads on Google when people search for what you offer.
Campaigns or ad groups by location, so budget follows each site's demand.
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Add early
Performance Max
One campaign across Search, Maps, YouTube, Display and Gmail, run by Google's AI.
Location asset groups help each site show on Maps, once conversion data is reliable.
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Start here
Local Services Ads
Pay-per-lead ads with a Google verification badge, for eligible local categories.
A profile per eligible location, each with its own budget and leads.
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Limited
Remarketing and Display
Ads shown to people who visited your site, across websites and apps.
Health services can't use remarketing lists. Fine for other services.
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Add later
Demand Gen and YouTube
Image and video ads on YouTube, Discover and Gmail that build demand.
Useful for new openings and service launches.
Selling to businesses, for example medical billing or IT services.
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Start here
Search
Text ads on Google when people search for what you offer.
Buyers search for the service by name, often with words like outsource, company or cost.
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Only with conditions
Performance Max
One campaign across Search, Maps, YouTube, Display and Gmail, run by Google's AI.
Without qualified-lead data it tends to chase cheap form fills. We add it once CRM outcomes flow back.
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Skip
Local Services Ads
Pay-per-lead ads with a Google verification badge, for eligible local categories.
Not available for most B2B services.
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Add early
Remarketing and Display
Ads shown to people who visited your site, across websites and apps.
Long sales cycles make reminders worth it, and B2B services can use remarketing lists.
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Add later
Demand Gen and YouTube
Image and video ads on YouTube, Discover and Gmail that build demand.
Video and image ads for awareness, once search is profitable.
Care delivered online, often across several states.
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After certification
Search
Text ads on Google when people search for what you offer.
Google requires certification before you advertise prescription services. Then search is the core channel.
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Only with conditions
Performance Max
One campaign across Search, Maps, YouTube, Display and Gmail, run by Google's AI.
Use with care: brand, URL and text controls matter for regulated claims.
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Skip
Local Services Ads
Pay-per-lead ads with a Google verification badge, for eligible local categories.
Built for providers that serve a local area in person.
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Limited
Remarketing and Display
Ads shown to people who visited your site, across websites and apps.
Health services can't use remarketing lists.
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Add later
Demand Gen and YouTube
Image and video ads on YouTube, Discover and Gmail that build demand.
For brand awareness, within Google's healthcare policy.
Results
Google Ads results from accounts we manage
Real figures from client Google Ads accounts, with the client type and period. Each one links to the project in our portfolio.
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13.7×Google Ads
Return on ad spend
Mental health clinic · Feb 2023 to Jun 2025
View project -
$1.53Google Ads
Cost per conversion, Q2 2025
Healthcare service provider · 4,867 conversions
View project -
643Google Ads
Leads on $2.74K ad spend
US medical billing company · B2B lead generation
View project -
24.8KGoogle Ads
Targeted clicks on $36.7K ad spend
Orthopedic clinic, Denver · Feb 2020 to Jun 2025
View project
Figures as reported in each client's Google Ads account. Results depend on market, budget and offer, so they are examples, not promises.
Weekly search-term review
The searches you pay for, and the ones we stop
Every week we read the actual searches that triggered your ads. This is what that review looks like for three kinds of business.
| Search term | What it means | What we do |
|---|---|---|
| emergency dentist open now | Urgent and ready to book | Keep, top priority |
| dental implants cost near me | Comparing prices for a high-value treatment | Keep |
| dental assistant jobs | Job seeker, not a patient | Add as negative |
| how to fix a chipped tooth at home | DIY research | Add as negative |
| free dental clinic | Looking for free care | Add as negative |
| [competitor name] dentist reviews | Checking a competitor | Separate campaign, if at all |
| Search term | What it means | What we do |
|---|---|---|
| orthopedic doctor accepting new patients | Ready to book a first visit | Keep, top priority |
| knee pain specialist near me | Problem-aware, likely patient | Keep |
| knee pain exercises | Self-care research | Add as negative |
| medical assistant jobs | Job seeker | Add as negative |
| orthopedic surgeon salary | Career research | Add as negative |
| [clinic name] patient portal login | Existing patient, not new demand | Exclude here |
| Search term | What it means | What we do |
|---|---|---|
| outsource medical billing for small practice | A practice ready to choose a vendor | Keep, top priority |
| medical billing company near me | Shopping for a provider | Keep |
| medical billing jobs remote | Job seeker | Add as negative |
| medical billing course online | Student | Add as negative |
| free medical billing software | Wants software, not a service | Add as negative |
| what is medical billing | Early research, not a buyer yet | Exclude; answer with content |
Examples for illustration. Negative keywords build into shared lists, so each week's review protects every campaign in your account.
Conversion tracking
We count calls and new clients, not page views
Smart bidding learns from whatever you tell Google is a conversion. Get that wrong and it optimizes for the wrong thing. This is the setup we use.
| Conversion action | How we track it | Used for bidding |
|---|---|---|
| Calls from your ads | Call assets, counted when a call passes a minimum length you choose | Yes |
| Calls from your website | Call tracking numbers that swap in for ad visitors | Yes |
| Form submissions | A confirmed submit event or thank-you page, set up in Google Tag Manager | Yes |
| Online bookings | The booking tool's confirmation event | Yes |
| Qualified leads | Lead status imported from your CRM with enhanced conversions for leads | Yes, higher value |
| New clients or closed deals | Imported from your CRM, with a value per client | Yes, highest value |
| Page views, scrolls and clicks | Recorded in GA4 for analysis | No, observed only |
- CRM imports, the current way
Since 15 June 2026, Google takes offline and enhanced-conversion uploads through its Data Manager instead of the Google Ads API. We set imports up that way. Google Ads Help
- Privacy built in
No conditions or patient details in URLs, forms or events sent to Google, and Consent Mode for visitors from the UK and EU.
- Tested before launch
We place test calls, forms and bookings and confirm each one reaches Google Ads before any budget goes live.
Account settings
Settings that quietly waste budget, and what we change
Many accounts lose money in settings nobody looks at after launch. We check each of these in every account we take on.
| Setting | What can go wrong | What we do |
|---|---|---|
| Location targeting | Ads can show to people who are only interested in your area, not in it | Target people in, or regularly in, the areas you serve |
| Networks on Search campaigns | Search partners and the Display Network can take budget from Google Search | Google Search only at launch; partners tested later with their own reporting |
| Auto-applied recommendations | Once switched on, they can change keywords, bids or budgets without your review | Reviewed and switched off where they'd change targeting or spend |
| Broad match | Matches loosely related searches, and budget follows them | Used only with smart bidding, clean conversion data and negative lists in place |
| AI Max for Search | Search term matching, text customization and final URL expansion can switch on with the upgrade | Final URL expansion off for regulated pages; text guidelines, exclusions and brand controls set |
| Performance Max | Can spend on your own brand searches and weak placements | Brand exclusions, negative keyword lists, search themes and the search terms report reviewed |
| Ad schedule | Ads run around the clock, including when nobody can answer the phone | Call-led campaigns run when your team can answer |
| Conversion goals | Every action counts the same, so cheap actions win | Primary goals set to calls, bookings and qualified leads, valued by quality |
Google excludes healthcare and other sensitive categories from ads inside AI Overviews, so for medical and dental practices the regular ad positions above and below the results are where paid search works. For other businesses, ads inside AI Overviews need AI-powered targeting such as broad match, AI Max, Performance Max or Dynamic Search Ads. You can't opt out, and Google doesn't report them separately. Google Ads Help
Ads and landing pages
An ad that matches the search, and a page that keeps its promise
Google and the person clicking judge your ad and landing page together. We write, test and fix both.
- Headline. Repeats the search and the location, so the ad matches what was typed.
- Description. Gives proof and a clear next step, within Google's policies for your industry.
- Sitelinks. Answer the next question: cost, team, reviews, booking.
- Call button. For people ready to talk. Shown only while someone can answer.
- Location. Links to your Business Profile, with distance and opening hours.
How we work
From account access to weekly management
You keep ownership from the first day, and you can see everything we change.
Getting started
Link your account
You accept our manager account request in Google Ads. You stay the owner and can remove us at any time. New accounts are created in your name.
Kickoff call
We agree what counts as a qualified lead, your target cost per lead, and the services and areas to advertise.
Audit and tracking
Tracking and settings are fixed before any campaign changes, so results can be trusted from day one.
Launch or restructure
New campaigns go live, or existing ones are rebuilt in stages so account history isn't lost.
Once you're live
Every week
- Search-term review and new negatives
- Budget pacing and bid checks
- Disapprovals and policy fixes
- Lead quality spot check
Every month
- Ad and asset tests
- Landing page review
- Report with cost per qualified lead
- Call to agree next priorities
Every quarter
- Account structure review
- Competitor and auction insights
- New campaign or channel tests
- Targets reset with you
Every change we make shows in your account's change history, with the date and who made it.
Budget planner
How much should you spend on Google Ads?
Work back from the clients you need. The starting values are examples, not benchmarks: your real cost per click comes from Google's Keyword Planner, or from us after an audit.
Monthly ad spend needed
$4,167 / month
- Clicks
- 694
- Leads
- 56
- Cost per lead
- $75
- Cost per qualified lead
- $125
- Qualified leads
- 33
- Cost per new client
- $417
Add our management fee for the full cost. If a new client costs more than one is worth to you, the fix is usually conversion rate or lead quality, not a bigger budget.
Add these numbers to my proposalFree Google Ads audit
Find out where your ad spend is going
Give us view-only access to your Google Ads account and we'll review it against your goals and competitors. You get a prioritized list of fixes, whether or not you work with us.
What the audit covers
8 areas- Conversion tracking accuracy
- Search terms and wasted spend
- Keywords, match types and negatives
- Campaign structure and budget split
- Bidding and automation settings
- Ads, assets and policy issues
- Landing page speed and message match
- Location, schedule and device settings
Delivered as a prioritized action plan, with the biggest savings at the top.
Client reviews
See what clients say about us
Read reviews from clients we have worked with on these platforms.
FAQ
Questions about Google Ads management
Something else? Ask us directly and we'll answer it in our reply.
How much does Google Ads management cost?
There are two parts: your ad spend, which you pay to Google directly, and our monthly management fee for strategy, builds, optimization and reporting. The fee depends on how many campaigns, locations and landing pages you need, and how much tracking needs fixing. We quote after an audit. The budget planner on this page estimates the ad spend side.
How much should we spend on Google Ads?
Work back from the clients you need. Your cost per click, landing page conversion rate and close rate set the budget, and the planner on this page does the maths. The budget has to buy enough clicks to learn which searches convert, and we will tell you before you spend it if it is too small for your market.
Will you use Performance Max and AI Max?
Where they fit. We use them once conversion tracking is reliable, with brand exclusions, negative keywords, URL controls and text guidelines in place. For lead generation without CRM data, we usually start with Search campaigns, where you can see and control the searches you pay for.
Can you take over our existing Google Ads account?
Yes. We audit first and keep your account history, so smart bidding keeps what it has learned. Tracking and settings are fixed before campaigns are restructured, and the rebuild happens in stages.
Who owns the Google Ads account?
You do. We work through manager access that you can remove at any time, and new accounts are created in your name and billed to your card. Your campaigns, history and conversion data stay with you if you leave.
How long before Google Ads brings in leads?
Ads can run within days of approval. The first weeks are spent learning which searches convert, and costs usually settle once enough conversions have been tracked. Each report shows cost per lead and per qualified lead, so you can see the trend.
Can you run Google Ads for healthcare and dental practices?
Yes. We follow Google's healthcare and medicines policy, avoid health-based remarketing and customer lists, and set up Local Services Ads where your category qualifies. Google also keeps healthcare ads out of AI Overviews, so we focus on the standard ad positions above and below the results.
Do you also manage Microsoft Advertising?
Yes, as part of a paid search plan. Microsoft Advertising can import your Google Ads campaigns, and we then adjust keywords, bids and budgets for its audience and costs.
Free Google Ads proposal
Let's turn your ad spend into qualified leads
Tell us about your business, current Google Ads spend and goals. We will review your account, search terms and landing pages, then recommend campaigns and a budget that fit.
Request a free proposal
We review your website first, then reply with the services and scope that fit.