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Know which ads book self-pay scans, without telling Google or Meta who booked.
Hippo is HIPAA-compliant ad tracking for imaging centers and radiology groups. It counts the scheduled exams, calls and price requests your ads produce, in an account you own, and keeps patient identities and exams out of what Google and Meta receive.
No annual contracts.
Transparent pricing.
We set it up for you.
An imaging patient starts as a scheduled exam, and most centers start advertising the day they post a cash price
Most imaging volume arrives on a physician's order, and no ad is involved. Centers start advertising when they sell an exam to consumers directly: a self-pay MRI, a calcium score, a DEXA scan, supplemental breast screening, with the cash price on the page. The path runs from ad click to the price page, then a call, a request form or a scheduler, then the scheduled exam and the completed one.
The scheduler usually sits on another site, and many patients still call. The booking also carries the exam name and the center's location. What the account counts as a conversion decides whether the numbers mean anything.
What is worth counting:
- a self-pay exam scheduled online
- a call from an ad that books an exam
- a price or estimate request
- a screening booked, such as a calcium score or a mammogram
What isn't:
- clicks
- price-page views
- form starts
A price campaign can fill the inbox with questions that never become a scheduled exam.
Here is the sum, with example numbers.
The sum, with example numbers
- Ad spend a month
- $2,000
- Self-pay exams scheduled
- 25
- Cost per scheduled exam
- $80
- Scheduled exams completed
- four in five
- A completed exam costs
- about $100
Example figures. Put in your own. Each line needs a count you trust, and the last one needs the campaign it came from.
Try the sum with your own numbers. If the scheduled exams are not tied to campaigns, that is the gap Hippo closes. It records the call, the request and the scheduler booking, ties each to the campaign that produced it, and sends the conversion to Google and Meta without the name, email, phone number, IP address or exam.
What imaging operators and their marketers say
They sell on price now
Cash prices, freestanding centers and patients who shop.
By cutting out the headaches of the insurance system and the hospital system, not having a facility fee that hospitals tend to add on
Physician owner, self-pay imaging center We were reluctant as a company to talk about money and price
Director of marketing, radiology group The independent imaging center in my town runs local ads about their lower prices and range of services, which helps them get patients.
Hospital imaging technologist 
They can't tell what's working
Website visits without scheduled exams, and owners counting the exams they need to break even.
If you’re not going to put the energy and the money into tracking, it’s probably not a good idea to go too far down a consumer path
Marketing director, radiology group So you’ve got a lot of people visiting your radiology group’s website, but you’re not getting any phone calls, consultations, or appointments.
Imaging marketing agency At $250, I would need five exams a week to break even and anything else would go towards profit.
Founder planning a cash-pay ultrasound practice
Google and Meta treat an imaging site as health content, and that shapes what you can measure
Imaging ads need no certification under Google's healthcare and medicines policy(opens in a new tab). A page about a disease, such as lung cancer screening, is a different matter: Google treats physical health conditions, including diseases(opens in a new tab), as a sensitive category, so you cannot use your own audience lists(opens in a new tab) for it: no Customer Match, no remarketing lists, no lookalikes. Health conversions cannot be measured with enhanced conversions(opens in a new tab) or offline uploads, and Google does not offer a BAA for Google Analytics(opens in a new tab).
Hippo changes none of that. It does not change ad approval or audience rules, adds no words, keywords or claims to your site, and changes no ad copy. It measures what happens after the click.
Meta
Meta sorts data sources into categories, and a site with a patient portal(opens in a new tab) is a named example of the health and wellness one. That category can block lower-funnel events(opens in a new tab) such as Schedule and Purchase, blocks custom events until they are reviewed(opens in a new tab), flags a custom conversion that names a condition(opens in a new tab), and you cannot change the category Meta assigns(opens in a new tab).
Meta's rules name medical procedures, treatments and testing(opens in a new tab) among the information it must not receive, the rule covers the names of your events(opens in a new tab), and its core setup strips anything in a URL after the domain(opens in a new tab). An event called "breast ultrasound booked" breaks it, and so does a price page whose address names the exam. Meta states that its own filters are no substitute for yours(opens in a new tab).
An event name, before and after
"breast ultrasound booked"Breaks Meta's terms
A neutral event nameWhat Hippo sends
Sent without the patient's
- name
- phone number
- IP address
- exam
With audiences closed off and lower-funnel events restricted, the events that still flow are what steer bidding. Hippo sends them under neutral names that carry no exam, no location and nothing that identifies the patient, and keeps a log of scheduled exams by campaign that is yours whatever Meta blocks.
Sources: Google, Healthcare and medicines(opens in a new tab) · Google, Health in personalized advertising(opens in a new tab) · Google, Personalized advertising(opens in a new tab) · Google, Customer data policies(opens in a new tab) · Google, HIPAA and Google Analytics(opens in a new tab) · Meta, Data source categories(opens in a new tab) · Meta, Data sharing restrictions(opens in a new tab) · Meta, Restrictions on custom conversions(opens in a new tab) · Meta, About prohibited information(opens in a new tab) · Meta, Core setup(opens in a new tab). As of 10/7/26.
HIPAA covers the center, and the wiretap laws are where the claims came from
Federal
HIPAA
An imaging center that submits claims electronically(opens in a new tab) is a covered entity, and its self-pay patients are still its patients. HHS names the page that matters: tracking on a page that permits individuals to schedule appointments(opens in a new tab) can reach PHI, and a tracking vendor receiving it is a business associate, and a BAA is required(opens in a new tab). HIPAA has no private right of action, which is why the cases below came under other laws.
Federal
Federal Wiretap Act
$10,000It allows statutory damages of $10,000 per plaintiff, and no proof of harm. It is the first count in the mammography provider's complaint, over what its scheduling page sent Google.
State
Florida
The Security of Communications Act(opens in a new tab) allows $100 a day or $1,000 per plaintiff, punitive damages and attorney's fees. It is the second count in the same complaint, for patients in Florida.
State
California
$5,000The state's privacy law(opens in a new tab) sets $5,000 per violation with no proof of harm, and its medical confidentiality law adds nominal damages of $1,000(opens in a new tab) for a provider of health care, whether or not it bills insurance.
State
Washington
The My Health My Data Act(opens in a new tab) covers health data HIPAA does not, which for a cash-only screening brand is all of it, including the visitor who read your price page and never booked.
Enforcement in Imaging & Radiology
Rayus Radiology(opens in a new tab)
Settled
Rayus Radiology settled claims(opens in a new tab) that it disclosed patients' information to Meta and other tracking technologies, and the court granted final approval(opens in a new tab) on December 18, 2025. Each valid claim receives $25. The settlement agreement(opens in a new tab) caps total payments at $18 million, and Rayus estimated it would pay $2 million to $5 million(opens in a new tab). The class was every patient with a portal account who visited the website.
Solis Mammography(opens in a new tab)
Pending
Patients allege that Solis Mammography(opens in a new tab) sent Google the exam and the center whenever someone booked, such as a diagnostic breast ultrasound at its Chandler, Arizona location. The case was filed in April 2026 and is paused while the parties mediate. The claims are allegations.
Life Line Screening(opens in a new tab)
$1.4 million
Life Line Screening, a preventive screening company, agreed to a $1.4 million settlement(opens in a new tab) over the Meta Pixel and other trackers on the pages where people booked screenings or bought test kits. The final approval hearing(opens in a new tab) was set for March 2026.
What the cases have in common:
The pages were booking pages.
Where a patient schedules an exam or a screening, and where the exam is named.
The tools were ordinary.
The Meta Pixel and Google's analytics and tag tools.
The class was defined by what patients did online.
Everyone who booked, or everyone with a portal account who visited the site.
The federal Wiretap Act reaches any imaging center with a scheduling page, and state laws add their own damages.
See what your scheduling page sends to Google and Meta →(opens in a new tab)How Hippo works
Your website
Book your appointment
Book now
Call us
Booking
Call
Hippo
Records events
Removes identifying information
Sends clean conversion data
Excluded from conversion events
Names
Conditions
IP addresses
Clean conversion events only
Google / Meta
Booking
Call
Remove the pixels that send PHI.
Take the Google and Meta pixels off your site.
Paste one snippet.
Hippo records visits, bookings, and calls, then removes patient names, health details, and IP addresses from the conversion events sent to Google and Meta.
Send clean conversions back to Google and Meta.
Google and Meta receive conversion signals they can use to optimize your campaigns. Patient names, health details, and IP addresses stay out of those events.
With your scheduler, your phones and your results portal untouched. Hippo runs on your own domain and records the call, the request and the scheduler booking. Your RIS, your scheduler and your portal stay as they are; what changes is what leaves the page. If an agency runs your ads, they keep their reporting and you keep the data and the accounts.
When the booking finishes on a scheduler on another site, Hippo counts it through its scheduling connections, so a scan booked off your site still lands on the campaign that produced it.
Supported integrations
Hippo works with the ad platforms and website tools your practice already uses.
Conversion
Hippo
What you get
Scheduled exams, by campaign
See which campaigns led to consult requests and bookings, and what each one cost.
Your numbers, in your account
An independent record of results in an account you own. If you change agencies, it stays with you.
Call tracking
Calls that start from an ad are counted as conversions alongside forms and bookings.
A record of what was sent
A log of every event that went to Google and Meta and what was removed from it first.
Pricing
1,000 visitors/month
$99/month
Month to month.
Start now, no demo call1,000 visitors/month(opens in a new tab)2,000 visitors/month
$199/month
Month to month.
Start now, no demo call2,000 visitors/month(opens in a new tab)10,000 visitors/month
$299/month
Month to month.
Start now, no demo call10,000 visitors/month(opens in a new tab)
Every plan includes:
- BAA signed at checkout
- No setup fees
- Cancel anytime. No compliance add-on that locks you in the day you enable it.
Server-side conversion tracking under a BAA, at a price a practice can actually pay.
Frequently asked questions
Most of our volume comes from referring physicians. Do we need this?
For referred exams, no: the order comes from the physician's office and no ad is involved. The day you sell a self-pay exam to consumers, such as a cash-price MRI, a calcium score, DEXA or supplemental breast screening, and pay for ads to fill it, you have a campaign to measure and a booking flow that carries the exam name. That is the part Hippo covers.
Our scheduling happens on another site, or on the phone. Can you count it?
Yes. Most imaging schedulers are a page on the vendor's own site reached from a "Schedule" button, and many patients call. Hippo counts the click and the call from your pages and the completed booking through its scheduling connections, so the campaign report shows scheduled exams, calls and requests together.
We post our cash prices. Does tracking on a price page matter?
The pages HHS names are the ones that follow the price page: a page that permits individuals to schedule appointments(opens in a new tab) and the logged-in portal. Meta separately prohibits medical procedures, treatments and testing(opens in a new tab) in event names and URL data, so a price page whose address names the exam should not reach Meta as it is. Hippo removes the path and the exam before anything leaves.
Our agency runs the ads. Who installs this?
We install it for you on a subdomain of your own domain; the agency keeps running the campaigns and reads the same conversions in Google Ads and Meta. The account, the conversions and the log stay yours, whichever agency runs the ads next year.
Meta cut our Schedule and Purchase events. Can Hippo get them back?
No. Hippo cannot lift a category Meta has assigned, and you cannot change it(opens in a new tab) either; under the health and wellness category Meta blocks specific mid- and lower-funnel events(opens in a new tab). What a compliant feed changes is what still flows: a booking sent with no exam in the name, no URL path and nothing that identifies the patient, and a log of scheduled exams by campaign that is yours whatever Meta blocks.
We are cash-only. Does HIPAA apply to us?
If the center bills Medicare or any insurer electronically(opens in a new tab) for any patient, it is a covered entity, and its self-pay patients are still its patients. A center that never bills a payer may fall outside HIPAA and still inside the wiretap laws the imaging cases were pleaded under, California's medical-privacy law and Washington's My Health My Data Act.
The lawsuits are against national chains. We are one center.
The classes in imaging were defined by what patients did on the website, not by the size of the defendant: the Rayus class was every patient with a portal account who visited the site, and the mammography complaint is built on what one center's scheduling page sent Google when a patient booked. A single center's site does the same things.
We advertise lung cancer screening and whole-body MRI. Will Google restrict the ads?
Imaging ads need no Google certification. What changes on a page about a disease is targeting: Google treats physical health conditions, including diseases(opens in a new tab), as a sensitive category and bars your own audience lists(opens in a new tab) for it. Hippo does not change ad approval or audience rules; it changes what the conversion signal contains.
Our results portal is on the same website as our marketing pages. Does that matter?
Yes. HHS says tracking on a patient portal's logged-in pages(opens in a new tab) generally has access to PHI, and that part of its guidance still stands. The Rayus settlement class was every patient with a portal account who visited the website. Hippo keeps ad tags off logged-in pages and sends nothing from them, so the portal stays out of what Google and Meta receive.
We already have call tracking with a BAA. Is this the same thing?
No. A call tracker records calls and can push them into Google Ads; it does not replace the Meta pixel or your analytics, and it does not carry the scheduler booking. Keep it if you use it. Hippo ties the call, the request and the booking to the campaign and sends Google and Meta a conversion with nothing that identifies the patient.
We have a cookie banner. Isn't that consent?
Not for what the booking sends. HHS says a cookie banner is not a HIPAA authorization(opens in a new tab), and the wiretap claims turn on what the scheduling page disclosed, which a banner does not change. Hippo waits for consent where it is required and removes identifiers before anything reaches Google or Meta.
Should we talk to a lawyer about the tracking on our website?
Yes, if you want to know how these laws apply to your center. This page describes laws, policies and court cases for general information and is not legal advice. Hippo handles the tracking; an attorney can advise you on your obligations.
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