Real appointment calls up 87% and cost per call down 45% in four months, after fixing tracking that had been counting page views as conversions.
Hridaya Heart Clinic is a cardiology practice in Lucknow. I worked on the account from March to June 2025, across Google Search, call tracking, GA4 and Google Tag Manager.
More appointment calls a month, from 38 to 71.
Lower cost per appointment call, from ₹1,579 to ₹873.
Share of spend on informational searches, down from 42%.
Share of reported conversions that are real calls, up from 9%.
What wasn’t working.
The account reported 410 conversions a month, yet the front desk took around 38 appointment calls from ads. A visit to the contact page counted as a conversion, so Smart Bidding was busy finding people who read pages, not patients who called.
- Broken tracking. Contact-page views were the main conversion. Real calls weren’t measured at all.
- Informational traffic. “Heart attack symptoms”, “ECG course” and “cardiologist salary” took 42% of spend.
- Generic page. The landing page didn’t show OPD timings, the doctor’s credentials or a clear call button.
Five changes, in the order they mattered.
Tracking audit and fix
Removed the page-view conversion. Calls from ads lasting 60 seconds or more, website call clicks with a forwarding number, and form submissions became the only conversions.
Search-term mining
An AI-assisted pass sorted four months of search terms into symptom research, jobs and education, and patient intent. I checked the groups and built the negative lists.
High-intent structure
Separate campaigns for consultations, echo and TMT tests, and second opinions, scheduled to OPD hours, with call ads at peak times.
A page made for calling
A landing page with the doctor’s credentials, OPD timings, accepted insurance and a fixed call button. Drafted with an LLM, reviewed line by line with the clinic.
A tracking alarm
A script emails me and the clinic if conversions drop to zero for 24 hours, so a broken tag never runs for weeks again.
What changed, month by month.
Reported conversions against real calls
What Google Ads reported against appointment calls logged at the front desk, before and after the tracking fix.
More calls for each rupee
Appointment calls a month (bars) against cost per appointment call (line). February is the baseline.
Spend by search intent
Share of monthly spend by the intent behind the search, before and after the negative lists and restructure.
Still running today
- A zero-conversion alarm checks the account every 24 hours.
- A search-term review script runs every week.
- A calls report goes to the clinic every Monday.
Tell me what you’re working on.
What you want to achieve, and where you need help. We can talk it through and decide on a practical next step. I’m based in New Delhi and work with businesses across India.
