Why TMHP-to-CAQH Data Transfers Break (and Cause Rejections)

A TMHP PEMS export and a CAQH ProView profile don't share a format, a field naming convention, or even consistent formatting for the same fact (a license number formatted one way in TMHP, another in CAQH). Every manual transcription between them is a chance to introduce an error that a payer catches later — and by then it's a rejection, not a typo.

Where it actually breaks

• NPI checksum failures — an NPI that fails its checksum should never be processed as-is; it needs to be flagged for review, not transcribed forward into CAQH
• Confidence, not certainty — every field pulled from a source document carries a confidence score. Only fields scoring 0.85 or higher are treated as a verified match eligible for transfer; anything below that requires a human to look at it first
• Guessing the gap — when a field is missing from the TMHP export entirely, the safe move is to leave it blank and flag it, not infer a plausible value from context

The fix isn't "be more careful"

Manual data entry can't consistently apply a confidence threshold across hundreds of fields per provider — that's a rule a system enforces, not a habit a person maintains under deadline pressure. TrueEnroll extracts every field with its full source lineage, scores it, and only marks a field eligible for transfer into CAQH if it clears the same 0.85 bar every time.

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