Google retains a click identifier for 90 days and matches hashed contact details for 63. An orthodontic case start regularly takes longer than either. This is not a tracking failure to be fixed, it is a limit to be designed around.
Google's maximum click through conversion window is 90 days, and it retains the click identifier for the same period. Its own documentation states plainly that it only keeps that identifier for 90 days, and an upload beyond it is rejected with a message saying the click is too old for its conversion to be imported. Enhanced conversions for leads, which match on hashed contact details rather than the identifier, allow 63 days.
Now put the Australian orthodontic funnel against that. A free consultation, a separately paid records appointment, a finance decision, and frequently a clinical decision to wait for a growth spurt. For a substantial share of cases the start falls outside both windows, at which point no amount of technical work will connect it to the click that produced it.
Google itself supplies the answer, in its documentation: if your conversion happens after 90 days, upload a different offline conversion event that happens within 90 days. Nobody in this category appears to have read that sentence and applied it.
It is paid, so it is a genuine commitment rather than a free enquiry. It is frequent enough to give the bidding something to learn from. And it almost always falls inside the 90 day window.
Because no Australian booking layer integrates with orthodontic practice software, this usually means your own web form writing to your own lead store, with the identifier attached at that moment.
This is a reconciliation between your lead store and the practice management system. On the two systems with real Australian presence it is a report export rather than an API call, because neither exposes a public one.
Weight the records appointment by the case value it typically leads to, so the bidding learns the difference between a simple case and a complex one where your practice records that.
Case starts remain the number the practice is run on. They are simply not a signal Google can act upon, and pretending otherwise produces reporting that quietly disagrees with the bank account.
United States orthodontic content generally recommends enhanced conversions, which upload hashed patient email and phone. Australian law points the other way. Health information is sensitive information under the Privacy Act, the fact of an orthodontic consultation qualifies, and the small business exemption does not apply to health service providers regardless of turnover, so every practice in the country is bound. Australian Privacy Principle 8 also makes the disclosing practice accountable for an overseas recipient's handling, even where it took reasonable precautions.
A click identifier upload sends an opaque identifier, an action, a timestamp and a value. No patient identifier crosses a border. It is also the one with the longer window, at 90 days against 63. So in Australia the privacy safer route and the technically better route are the same route, which is the opposite of the advice imported from overseas.
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