URBN Dental was spending tens of thousands a month on search with almost nothing to show for it. In one month of account rebuild, cost per booked appointment nearly halved and the channel turned properly profitable.
A quick read of how the account moved from losing money to funding its own growth.
URBN Dental runs 11 clinics across Houston's highest-income areas. Before we took over in June 2025, Google Ads had spent $42,000 to generate just $23,000 in new-patient revenue, a 0.55× return. Close to $19,000 was lost outright, making the channel cash-negative and unsustainable at that spend level.
Spend concentrated on competitor brand terms, insurance-related searches the practice doesn't accept, and bargain-intent queries such as "cheap," "no cost" and "free," paired with dentist, dentistry and implants.
Success was counted as clicks on the call button, not real calls, and not calls lasting over 60 seconds. Lead quality and actual demand were effectively invisible.
9 of the 11 locations sit within a 6km radius. Budget from one clinic routinely spent on another: one clinic landed zero new patients while another took 70 new patients from a $5,000 budget.
Lead counts looked healthy on the surface. Booked appointments stayed low regardless, spend and real results had come apart.
Per the same period's patient-value report: average revenue per booked patient was just $899 account-wide, $824 from Google Ads specifically.
No new campaigns and no bigger budget, just fixing what was broken in the structure, the measurement, and the geography.
Systematically excluded the terms that were never going to convert: insurance searches, competitor brand names, bargain-intent queries. Over 0 negative keywords added to date.
Re-pointed success metrics to what actually matters: online bookings and booked phone calls, not clicks on a call button.
Replaced broad, overlapping targeting with small, clinic-specific radii, so neighbouring locations stopped bidding against each other. Overlap cut by roughly 0% after testing.
We took over the account in July 2025. That first month, $33,000 in spend generated $79,398 in new-patient revenue, a 2.39× return counting first visits alone. Using conservative dental lifetime-value assumptions, the true revenue impact of that same spend sits between $237,000 and $395,000.
Average value per patient more than doubled month over month, from $899 in June to $2,036 in July.
Total revenue tied to Google Ads in January: $95,173 already collected ($82,831 from Google Ads directly, the rest from call extensions), plus 19 future-dated appointments averaging $942 each. Every one of these bookings is non-branded search; nothing here is inflated by brand terms or repeat calls.
Blended across every channel, the funnel above converts at 72%. Isolate pure Google Ads clicks and it climbs to 90% (168 booked from 186 leads); call-extension traffic is what drags the blended rate down.
If your paid search spend is hard to defend in a board meeting, we'll show you exactly where it's going and what to do about it.
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