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Frequently Asked Questions

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Our practice charges all patients a retainer for services.

The Medical Weight Loss program retainer is $500/month for the duration of the program. This retainer applies to services provided during the program from our office including non-medical health coaching services such as health coaching visits, group coaching, weight-loss counseling, integrated smart equipment. This retainer also covers email and text messaging access to our staff, health coaches, and physicians.

The Primary Care programs the retainer is tiered based on your age between $200-250/month. This retainer applies to services provided during the program from our office including non-medical health coaching services such as health coaching visits, group coaching, weight-loss counseling,  This retainer also covers email and text messaging access to our staff, health coaches, and physicians. This retainer also enables us to schedule urgent visits and if necessary same-day visits.

Yes, there are additional charges for services that are not included in your program covered by your retainer.  If additional services are needed or medically necessary, we will submit out-of-network claims for physician visits and other medical services to your insurance for coverage. We will work with your insurance company to have these services covered.
After we submit claims, our office and you will receive an explanation of benefits and the insurance may assign the checks to you for our services. We ask that you submit these checks to us either by USPS or dropping them off during your visit to apply to your account.

Our list of charges for medical services are as follows:

  • New Office Visit: $750
    • This includes the time to review your medical records, a 30-minute onboarding call with our staff, a 15-minute introductory call with our health coaches and a 90-minute meeting with one of our doctors.
  • Follow-up Visits: $250
    • This includes follow-up with one of our doctors, this may also include additional time with a health coach
  • Remote Physiologic Monitoring: $100/month
    • This includes reviewing the multiple data points our practice monitors remotely, which may include: ECG, Weight, Body Composition, Glucose, Blood Pressure Readings, Holter, Water Weight, Continuous Glucose
  • Lab Tests: $25/test each
    • Including: Hgb/Hct, CMP, Lipid Panel,, Hba1c, Ketones, Urinalysis, Influenza, Strep, and any other testing onsite
  • Spirometry: $100.00
    • This is a breathing test to assess your lung function
  • EKG 12-lead: $100.00
    • This is a 12-lead test of the electrical conductivity of your heart
  • Bioimpedance: $50.00
    • This is a 8-point, full body, body-composition scale which also estimates your visceral fat
  • Ambulatory Blood Pressure: $300.00
    • This includes a device that captures your continuous blood pressure reading over 48 hours which we review to determine the patterns of your blood pressure

We pride ourselves in serving our patients and can work out arrangements to make sure you get the care you need without financial hardship. Delivering excellent patient care is our first and utmost priority.  Insurance coverage will never compromise our level of care. We have worked with hundreds of patients with great success, with varying insurance coverage.

Please note, we do not participate in Medicare or Medicaid, and furthermore our bills CANNOT be submitted to them for reimbursement.

Dr. Tro Kalayjian is licensed to practice Medicine in  AL, AZ, CA, CO, CT, DE, FL, GA, ID, IL, IN, IA, KS, KY, LA, ME, MD, MA, MI, MN, MS, MT, NE, NV, NH, NJ, NM, NY, NC, ND, OH, OK, PA, SD, TN, TX, UT, VT, VA, WA, WI, WY in these states he can order lab work, make diagnoses, & prescribe medications. If you are located outside of these states, sign up for our health coaching programs with one of our ACE-certified health coaches. Please be advised that health coaching is NOT medical advice.  Health coaching does not establish a patient-physician relationship. Our health coaches CAN provide education and support but they CANNOT make any medical diagnoses, prescribe medications, or alter medical plans.  Call our office for more details regarding our health coaching plan.

  • Health Coaching programs require a 3-month minimum with a 30-day notice of cancellation.
  • Medical Weight Loss programs require a full 6-month commitment to the program.
  • Group Coaching program has a 4-month minimum.
  • Direct Primary Care programs have a minimum 12-month commitment.

Currently enrolled weight loss, primary care patient and health clients have access to your group coaching program, which is designed to be a support group for weight loss and sustained lifestyle change. If you would like to enroll in our group coaching plan you may do so by completing an initial, private, health coaching session prior to participating in our Monthly Group Coaching Sessions. Group Coaching requires a 4-month minimum commitment and is billed monthly upon enrollment and will be automatically charged on the same date each month. The monthly fees you pay are a retainer for Group Coaching sessions only and do not establish a physician-patient relationship. Group Coaching is for educational purposes only and is not to be considered medical advice. The payments for group Coaching is nonrefundable, nontransferable, cannot be prorated, and cannot be banked. All sessions are meant to be completed consecutively upon enrollment. Should you miss a Group Coaching session, you lose that session and it cannot be made-up.

Cholesterol & Heart Disease

  • Changes in cholesterol can occur on a low carbohydrate or ketogenic diet, particularly changes in HDL, triglycerides, and LDL.
  • We will monitor these changes closely to ensure your labs are trending in an overall healthy direction.
  • Of note, LDL can in some patients increase and we can further risk stratify these changes with tests like a CIMT, CAC score and an advanced lipid profile.

Kidney Stones

  • There is a theoretically increased risk of kidney stones with any significant weight loss, and particularly with low carbohydrate approaches there can be an increase in urinary excretion of salt and calcium.
  • Although 2-year data interventional trial data have not demonstrated a significant increase in risk in kidney stones, there is a theoretically increased risk of kidney stones.
  • We recommend patients hydrate to mitigate these risks, to some extent.


  • The risk of ketoacidosis is worth mentioning particularly in patients with Type 1 Diabetes, pregnant patients, lactating patients, and patients on certain medications.
  • We can advise you on how to mitigate these risks in our program.


  • Lowering carbohydrates and fasting can lead to a lowering of blood sugar.
  • These diets are generally well tolerated by patients, but hypoglycemia is certainly a risk in some athletes and patients on certain medications
  • In our program, we will work with you to lower these risks.

There are some other minor risks, like constipation, and questions about effects on diverticulitis which we will discuss with you during our medical program.

Yes, we do support other approaches besides low carbohydrate, ketogenic, and intermittent fasting.

  • We have used various diets with success in our patients, including caloric restriction, strict-vegetarian, whole-food plant-based, meal replacement options as well as flexible dieting
  • In some of our patients, we can use medications to help with satiety, appetite and weight loss.
  • In some of our patients, we recommend surgery in addition to diet and lifestyle changes.

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Our Location


84 Route 303

Tappan, NY 10983

Phone: 845-397-CURE

Fax: 888-674-7069