Real-time bidding (RTB) is a core component of programmatic advertising. RTB allows for the buying and selling of individual ad impressions in real-time automated auctions. Think of it as a stock exchange, but for digital ad space. 

The entire RTB process happens in the time it takes for a webpage or app to load. Here’s a breakdown of how it works:

Advertiser Side (Demand-Side Platforms – DSPs)

Advertisers set up campaigns in a DSP, defining things like target audience, budget, bidding strategy, and ad creatives.

The DSP will build pieces of code called bidders, which are responsible for responding to the auction in a matter of millisecond.

Step 2. Publisher Side (Supply-Side Platforms – SSPs)

Publishers (like websites, apps, or CTV platforms) make their ad inventory available through SSPs.

The SSP connects with multiple ad exchanges and DSPs to maximize competition for each impression.

When someone loads a webpage or app that has ad space, the SSP sends a bid request to the ad exchange.

User demographics (age, location, device, etc.)

The ad exchange passes the request to multiple DSPs.

Each DSP quickly evaluates the impression against the advertiser’s targeting rules.

If it’s relevant, the DSP submits a bid (e.g., $2.50 CPM).

If not, the DSP skips bidding or send back a 'No Bid' signal.

The winning ad creative is instantly sent back to the publisher’s page.

The ad loads alongside the webpage, and the user sees it within milliseconds—without noticing the auction happened behind the scenes.

Although there are a lot of moving pieces, an RTB auction is extremely fast—in the range of 100 to 200 milliseconds (0.1–0.2 seconds). To put this into perspective: it's faster than a blink of the eye! 

There are five key players in the RTB ecosystem. Here’s an overview: 

Rate card viewer

RTB overview

The creative is temporarily stopped from being served. You would use this status to pause a specific ad without deactivating the entire campaign. A inactive creative must be changed to active to be assigned to an ad group.

Inactive

A creative must be active to be assigned to an ad group.

Active

A inactive creative must be changed to active to be assigned to an ad group. 

A creative must be active to be assigned to an ad group. 

The Cadent platform attempts to deliver the daily goal as quickly as possible.

Intraday_pacing_ASAP

The Cadent platform spreads the daily goal evenly across every hour and then every minute of a given day.

Intraday_pacing_Even

The rate an impression buying/spend is distributed throughout the day. Options are: ASAP and evenly

Intraday_pacing

The management and tracking of ad spend or impression delivery over a campaign's lifespan to ensure the budget is fully utilized by the end date without overspending or underspending.

Pacing_towards

The amount of money allocated to a single line item.

Budget

The max bid Ad Manager will send to an exchange. For example, if we calculate a dynamic bid of $15, but the max possible CPM is $10, we send a bid of $10.

Max_possible_CPM

This sets the min price for the inventory that Ad Manager will bid on after dynamic bidding has calculated a price. For example, if you set a min possible CPM of $1, and dynamic bidding calculated the bid to be $0.5, we filter out that request. 

Min_Possible_CPM

Target_CPU_ceiling

This sets the minimum CPU you're willing to allow.

Target_CPU_floor

The desired CPU based on the primary model score for a given bid request. This field can also act as a bid multiplier based on the primary model.

Target

The maximum eCPM you're willing to allow for a given ad group.

eCPM_price_ceiling

The maximum CPM you'll allow for an individual bid, regardless of eCPM.

CPM_Bid_Ceiling

The bid price sent to an exchange for a given bid request.

CPM_Bid

This sets the minimum CPM you're willing to allow.

CPM_Bid_Floor

Cost per user (CPU) is the amount of money spent to acquire a new user who performs a desired action, such as signing up, making a purchase, or subscribing to a service.

A model is a collection of mathematical functions that scores each bid request based on the likelihood that serving an impression will achieve the model's goal. Models are set at the ad group level. 

model_score

A URL that points to an XML document containing information for serving an audio ad. It acts as a bridge between an ad server and a media player, allowing the player to request and display audio ads according to these instructions.

audio_VAST_tag_URL

A Google Sheet or exported file from Google Campaign Manager (GCM) that organizes ad tags and is used for bulk uploading. Cadent supports .xlsx or .xls Google tag sheets.  

Google_tag_sheet

A VAST (Video Ad Serving Template) tag URL is a link that initiates the video ad-serving process. This URL tells the video player where to find the ad, what format it is, how long it is, and what actions to track (like views or clicks).

VAST_tag_URL

The markup type can be a 1x1 image tag or a JS tag. 

Markup_type

This is the 'who not to target' list. Negative targeting is used to filter out irrelevant audiences and helps prevent your ads from showing to users who are unlikely to be interested.

negative

Positive targeting is the 'who to target' list. For example, if you sell running shoes, you might positively target users interested in "sports," "fitness," and "marathons."

positive

A VAST (Video Ad Serving Template) tag is a URL (or XML snippet) that tells a video player where to fetch an ad from and how to track it.

VAST_tag

A tracking tag is a piece of HTML or JS code that's placed on a webpage to track visitor activity for reporting and attribution purposes.

tracking_tag

The webpage a user is directed to when they click your ad.

Clickthrough_URL

An activity is a way to further define the universal tag. You'll use an activity to log universal tag fires and for the purpose of retargeting users. You need to create a universal tag before you add activities.

activity

An activity is a way to further define the universal tag. You'll use an activity to log un

This pixel type is used to track a click action when there is no change in the URL. For example, if you want to track a specific action, like a "Buy now" button. The Action activity can be placed on the specific button HTML to be tracked.

action_activity

A single JavaScript pixel placed in a shared code section, to automate the collection of data across every page of the site. A universal tag doesn't replace current pixels or static tags, it's additional functionality that increases mapping.

universal_tag

A deal ID is a unique identifier that establishes a direct connection between a publisher and advertiser.

Deal_ID

Negative targeting means the these attribute items are specifically excluded from your audience. This helps to improve targeting and reduce wasted ad spend.

negatively_targeted

 Current Procedural Terminology (CPT) codes are a standardized set of medical codes used to describe medical, surgical, and diagnostic procedures.

Healthcare Common Procedure Coding System (HCPCS) codes are a standardized set of codes used by healthcare providers to submit claims for medical procedures, supplies, products, and services

HCPCS

International Classification of Diseases, 10th Revision (ICD-10) is a diagnostic and procedure coding system endorsed by the World Health Organization (WHO). 

ICD-10

Unknown means a patient's gender wasn't captured. You might notice the unknown count is higher when you select the Pharmacy attribute. 

unknown

DMAs are geographic regions used to define television and radio markets.

DMAs

HCP stands for Healthcare Professional. It refers to individuals who are licensed and trained to provide healthcare services to patients. For example, doctors, nurses, and pharmacists. 

This is the count of patients in a Predictive Health Audience. Each patient is counted only once. 

Distinct_Patients

Attribute items within a group use -OR- logic (asthma -OR- appendicitis). Attribute items in different groups use -AND logic (asthma -AND- appendicitis).  

group

If you don't want specific attribute items in your predictive health audience, add it to the exclusions list. 

Exclusions

The seven health-specific categories you'll select to build a predictive health audience. They include: Diagnosis, Procedure, HCP, Rx, Pharmacy, Insurance, and Patient Info

attributes

A specific data point within an attribute. For example, 0054-0326 fluticasone propionate and salmeterol, and 0054-0327 fluticasone propionate and salmeterol are both RX attribute items. 

attribute_items

This determines whose data is the source of truth for the line item's KPI metrics. For example, if you set Cadent, the system will reference Cadent data for your KPI metrics.

Metrics_Primary_Partner

Sets an impression cap across all flights in this line item. 

Impression_Cap_Multiplier_

The target number of impressions that a campaign's line item will serve.

Impression_goal

Cost per mille (CPM) refers to the average cost per 1,000 advertisement impressions. Mille means 1,000 in Latin. 

The maximum number of impressions per the selected time interval. (e.g., 10 times per month). 

Impression_limit

A frequency cap limits the number of impressions on specific IDs within a defined timeframe. A frequency cap can help you optimize spend and prevent ad fatigue.

Frequency_cap

This field is used for reporting. It doesn't affect your campaign. 

Purchase_order_ID

A click-through URL is a specific webpage that the user is directed to when they click your ad

Click-through_URL

A snippet of code that's placed on a webpage, to define exactly where and what ad will be displayed.

Ad_tag

A display ad shown alongside a video or audio ad, usually displayed on top of or along the side of the player.

Companion_ad

This ID is found in the third-party ad tag or third-party tracking tag. It's used to map the creative to the third-party ad server. 

Third-party_placement_ID

Stands for Mobile Rich Media Ad Interface Definitions and creates a standard way for display ads to be interactive, so you can swipe or tap on them.

MRAID

Creative Type is a required selection, you should select the option that best matches the type of creative you are uploading.

Creative_Type

MIMEtype

The measure data used to encode a single second of video. The higher the bitrate the higher the video quality.

Bitrate

The total runtime of the video creative. 

Duration

Video Player Ad-Serving Interface Definition (VPAID) establishes a common interface between video players and ad units, enabling video ads to be interactive (e.g. swiping or tapping).