The ability to judge whether a caption correctly describes an image is a critical part of vision-language understanding. However, state-of-the-art models often misinterpret the correctness of fine-grained details, leading to errors in outputs such as hallucinating objects in generated captions or poor compositional reasoning. In this work, we explore Token-Level Confidence, or TLC, as a simple yet surprisingly effective method to assess caption correctness. Specifically, we fine-tune a vision-language model on image captioning, input an image and proposed caption to the model, and aggregate either algebraic or learned token confidences over words or sequences to estimate image-caption consistency. Compared to sequence-level scores from pretrained models, TLC with algebraic confidence measures achieves a relative improvement in accuracy by 10% on verb understanding in SVO-Probes and outperforms prior state-of-the-art in image and group scores for compositional reasoning in Winoground by a relative 37% and 9%, respectively. When training data are available, a learned confidence estimator provides further improved performance, reducing object hallucination rates in MS COCO Captions by a relative 30% over the original model and setting a new state-of-the-art.