Google Ads call tracking: count the calls your ads really drive

Why calls are the conversion practices undercount

A searcher who taps your number in the ad never visits your website, so a website-only setup misses them entirely. Another reads your service page and dials the number from memory, and that call looks like nothing happened. Meanwhile the form submissions you do count make the account look as if forms are all that matter.

The result: Google is told the wrong story and bids for the wrong searches. Fixing it takes two Google features and one decision about call length.

If you're unsure what your account counts today, a free marketing audit reviews your ads alongside your website and Google listing.

Call assets: calls straight from the ad

Call assets (opens in a new tab) "let you add phone numbers to your ads." On phones, a tap-to-call button appears under your ad; on desktop, a "Call us" button shows your number with a QR code that opens a phone's dialer.

Steps:

1. Add a call asset with your main office number to your Search campaign.
2. Under advanced options, schedule it to appear only when someone can answer. Google: "You can set numbers to appear only when your business can accept calls."
3. Turn on call reporting in account settings. Google then creates a default "Calls from ads" conversion action.
4. Set the conversion's minimum call length (see below) and counting to "One" per click (counting options (opens in a new tab)).

Call reporting (opens in a new tab) runs on Google forwarding numbers and shows details such as start time, duration, whether the call connected and, for calls over 15 seconds, the caller's number. One practical note for your front desk: Google says that "on some calls, Caller ID shows a Google number, not the user's number." Call assets targeting the Display Network don't support forwarding numbers.

Calls from your website after an ad click

Website call tracking covers people who click the ad, read your page, then call. Google swaps a Google forwarding number (opens in a new tab) onto your site for visitors who arrived from an ad, which Google says comes "without any cost to you," and ties each call to the keyword and ad (website call setup (opens in a new tab)).

Steps:

1. Confirm your country is eligible. Both the United States and Canada are on Google's forwarding-number list (checked October 22, 2026).
2. Create a phone-call conversion for calls to a number on your website.
3. Add the Google tag and the phone snippet to your site; your web developer or website platform handles this.
4. Make sure your number appears as text on the page so it can be swapped.
5. Test: click your own ad, call the number shown, and confirm the conversion records.

If your site already uses a third-party call-tracking script with dynamic numbers, Google notes its automated verification can't check your number by scanning the page source. Pick one system to own website numbers so they don't overwrite each other.

Call-length thresholds that mean a real inquiry

A call counts as a conversion only if it lasts longer than the minimum you set. Too short and hang-ups count; too long and quick bookings get missed.

To set yours:

1. Time a sample of real new-patient calls, including any phone menu and hold time.
2. Time a sample of calls you don't want counted: existing-patient reschedules, vendors, wrong numbers.
3. Set the threshold between the two.
4. Review after a month and adjust.

Third-party call tracking and HIPAA: recordings, transcripts, BAAs

Third-party call-tracking tools add features Google doesn't: unique numbers per channel, call recording, transcripts and AI summaries. For a practice, those features carry the risk.

When patients describe symptoms, medications or insurance on a call, a recording or transcript can contain protected health information. A vendor that creates, receives, maintains or transmits protected health information on your behalf meets HIPAA's definition of a business associate (45 CFR 160.103 (opens in a new tab)). A practice may let a business associate handle that information only with satisfactory assurances, documented in a contract (45 CFR 164.502(e) (opens in a new tab)), which is the BAA.

Before you buy:

• Ask whether the vendor will sign a BAA, and on which plan.
• Turn off recording and transcription unless you have a clear use for them.
• Don't let the tool send call content, keywords tied to callers or transcripts into ad platforms.
• Check consent rules for recording calls where you operate.

We go deeper in call tracking and HIPAA. This is general information, not legal advice. Confirm how it applies to your practice with a qualified advisor.

Matching calls to booked appointments

Google counts calls; your schedule counts patients. Connect the two with aggregate numbers, not individual callers.

1. Ask and log the source. The front desk asks new callers how they found you and records it in your practice management system.
2. Compare monthly by service. Calls from ads (Google) against new patients who said "Google ad" or "search" (your records).
3. Track the ratio. If 40 counted calls produce 12 new patients, your call-to-patient rate is 30%. Watch it move as you change ads, pages or phone handling.
4. Don't upload caller lists to Google. Matching individual phone numbers to booked care sends health information to an ad platform; get legal review before any such import.

Common mistakes

• Counting every call, including 5-second hang-ups.
• Running Google forwarding numbers and a third-party script that overwrite each other.
• Call assets showing at night when nobody answers.
• Forgetting calls from your Google Business Profile, which are a separate channel; see calls from your Business Profile.
• Never re-testing after a website change.

Where Medfy fits: its first-party website analytics count calls, forms, bookings and directions by source, so you can see which channels drive inquiries. Medfy doesn't issue tracking numbers, record calls or produce transcripts. See how Medfy handles patient data. For forms and booking clicks, read Google Ads conversion tracking; to check everything at once, run the Google Ads audit; and for the bigger picture, Google Ads for medical practices.

Frequently asked questions

How do I track phone calls from Google Ads?

Use two Google features. Call assets add your number to the ad and, with call reporting on, count 'Calls from ads.' Website call tracking swaps a Google forwarding number onto your site for visitors who came from an ad, so you can see which keyword led to the call. Set a minimum call length for both so hang-ups and wrong numbers don't count.

Is call recording HIPAA compliant?

Recording isn't compliant or non-compliant by itself. When patients describe symptoms, insurance or appointments, a recording or transcript can contain protected health information, so a vendor that stores or processes it for your practice is likely a business associate that must sign a BAA. Also check consent rules for recording calls where you operate. Confirm the details with a qualified advisor first.

What call length should count as a conversion?

Pick a length that separates real inquiries from hang-ups, wrong numbers and quick questions. Sixty seconds is a common starting assumption, and Google has described it as the default. Then test it: time a sample of real new-patient calls at your front desk, including hold time and phone menus, and adjust after a month of data.

Do Google forwarding numbers work in Canada?

Yes. Google lists Canada and the United States among the countries where Google forwarding numbers are available, so Canadian clinics can use call reporting for call assets and website call conversions. Check the list again before launch, because availability and number types vary by country. Run Canadian locations in their own campaigns so reporting and budgets stay separate.