diff --git a/admin/src/api/followupAudio.ts b/admin/src/api/followupAudio.ts
index 9cfc481c8..0680c128f 100644
--- a/admin/src/api/followupAudio.ts
+++ b/admin/src/api/followupAudio.ts
@@ -25,6 +25,8 @@ export interface FollowupCapabilities {
     audio_verified: boolean
     preview_only?: boolean
     preview_ready?: boolean
+    manual_review_enabled?: boolean
+    manual_review_ready?: boolean
     can_review?: boolean
     test_scope_allowed?: boolean
     can_upload: boolean
diff --git a/admin/src/views/tcm/diagnosis/components/FollowupAudioPanel.vue b/admin/src/views/tcm/diagnosis/components/FollowupAudioPanel.vue
index 61d35ef67..1f95b7170 100644
--- a/admin/src/views/tcm/diagnosis/components/FollowupAudioPanel.vue
+++ b/admin/src/views/tcm/diagnosis/components/FollowupAudioPanel.vue
@@ -12,12 +12,12 @@
             </div>
         </div>
         <div v-if="helpVisible" class="help-box">
-            <p v-if="previewOnly">当前仅开放测试识别与提炼，可核对并保存审核草稿；测试预览任务不提供病历、日常记录或备注的确认写入。</p>
+            <p v-if="previewOnly">{{ capabilities.preview_only ? '当前仅开放测试识别与提炼，可核对并保存审核草稿；测试预览任务不提供确认写入。' : '这是历史测试任务，不写入病例；新上传的真实录音可按正常业务流程审核后确认入单。' }}</p>
             <p v-else>录音只生成建议，不会自动写入。逐项核对后选择采纳，再确认写入；日常记录按日期和时段分别保留。</p>
             <p>仅当前可见标签页每 5 秒刷新；已编辑内容不会被覆盖。后台分析不受关闭页面影响，未知结果请先核对任务或账单，勿重复上传。</p>
             <p v-if="detail">任务 #{{ detail.id }} · 版本 {{ detail.version }} · 保留至 {{ formatExpiry(detail.expires_at) }}</p>
         </div>
-        <el-alert v-if="previewOnly" type="warning" :closable="false" title="仅测试识别与提炼，不写入病例" description="可保存审核草稿；预览就绪不代表完整音频或准确度验收通过，不允许确认写入病历、日常记录或备注。" show-icon />
+        <el-alert v-if="previewOnly" type="warning" :closable="false" :title="capabilities.preview_only ? '仅测试识别与提炼，不写入病例' : '历史测试任务，仅供查看和审阅'" description="此任务保留测试用途。新业务录音请新建任务，人工核对后确认入单。" show-icon />
         <el-alert v-if="!audioReady" type="warning" :closable="false" :title="capabilities.preview_only ? '测试预览尚未就绪，暂不可上传或重试。已有任务可查看。' : '当前环境尚未通过音频能力验证，暂不可上传或重试。已有任务可查看。'" />
         <el-alert v-else-if="capabilities.can_upload && !capabilities.models.length" type="warning" :closable="false" title="暂无可用的分析模型，暂不可上传。已有任务可查看。" />
         <el-alert v-if="basicDirty" type="warning" :closable="false" :title="previewOnly ? '病历有未保存修改，测试预览不会覆盖这些修改。' : '病历有未保存修改，请先保存病历，再写入录音建议。'" />
diff --git a/admin/src/views/tcm/diagnosis/components/followupAudioState.ts b/admin/src/views/tcm/diagnosis/components/followupAudioState.ts
index b788f9a78..7970c5184 100644
--- a/admin/src/views/tcm/diagnosis/components/followupAudioState.ts
+++ b/admin/src/views/tcm/diagnosis/components/followupAudioState.ts
@@ -112,13 +112,13 @@ export function followupFeatureEnabled(caps: FollowupCapabilities | null): boole
     return !!caps?.enabled && (!caps.preview_only || caps.test_scope_allowed === true)
 }
 export function followupAudioReady(caps: FollowupCapabilities | null): boolean {
-    return !!caps && (caps.preview_only ? caps.preview_ready === true && caps.test_scope_allowed === true : caps.audio_verified)
+    return !!caps && (caps.preview_only ? caps.preview_ready === true && caps.test_scope_allowed === true : caps.audio_verified || (caps.manual_review_enabled === true && caps.manual_review_ready === true))
 }
 export function followupCanReview(caps: FollowupCapabilities | null, previewTask = false): boolean {
     return followupFeatureEnabled(caps) && !!caps && (caps.preview_only || previewTask ? caps.can_review === true : caps.can_apply)
 }
 export function followupCanApply(caps: FollowupCapabilities | null, previewTask = false): boolean {
-    return followupFeatureEnabled(caps) && !!caps && !caps.preview_only && !previewTask && caps.can_apply
+    return followupFeatureEnabled(caps) && followupAudioReady(caps) && !!caps && !caps.preview_only && !previewTask && caps.can_apply
 }
 export function uploadIssue(file: Pick<File, 'size' | 'name'> | null, recordedAt: string, model: string, caps: FollowupCapabilities | null, viewOnly: boolean): string {
     if (viewOnly || !caps || !followupFeatureEnabled(caps) || !followupAudioReady(caps) || !caps.can_upload) return '当前不可上传录音'
diff --git a/admin/tests/followup-audio.test.cjs b/admin/tests/followup-audio.test.cjs
index 3a6a000c5..c4c9fc9c0 100644
--- a/admin/tests/followup-audio.test.cjs
+++ b/admin/tests/followup-audio.test.cjs
@@ -1249,9 +1249,9 @@ test('preview actual component can upload, view transcript and save draft with f
     assert.match(f.panel.applyIssue.value, /测试预览/)
     f.dispose()
     const source = fs.readFileSync(path.join(componentDir, 'FollowupAudioPanel.vue'), 'utf8')
-    assert.match(source, /v-if="previewOnly"[^>]+title="仅测试识别与提炼，不写入病例"/)
+    assert.match(source, /v-if="previewOnly"[^>]+:title="capabilities.preview_only/)
     assert.match(source, /<el-button v-if="canApplyReview"[^>]+@click="applySelected">确认写入/)
-    assert.match(source, /预览就绪不代表完整音频或准确度验收通过/)
+    assert.match(source, /历史测试任务，仅供查看和审阅/)
 })
 
 test('preview roles and review_refreshed drafts remain editable without can_apply and preserve dirty work', async () => {
@@ -1442,3 +1442,20 @@ test('dirty draft is replaced by the authoritative applied result from another o
     assert.deepEqual(f.events, [['applied', 10]])
     f.dispose()
 })
+
+
+test('manual human-reviewed business mode exposes upload and explicit Apply without claiming model accuracy', async () => {
+    const manual = { ...caps(), audio_verified: false, preview_only: false, manual_review_enabled: true, manual_review_ready: true, can_review: true }
+    assert.equal(state.followupAudioReady(manual), true)
+    assert.equal(state.followupCanApply(manual), true)
+    assert.equal(state.followupCanApply(manual, true), false)
+    assert.equal(state.followupAudioReady({ ...manual, manual_review_enabled: false }), false)
+    assert.equal(state.followupCanApply({ ...manual, manual_review_ready: false }), false)
+    assert.equal(state.followupAudioReady({ ...manual, manual_review_ready: undefined }), false)
+    const f = setupPanel({}, { capabilities: manual }); await settle(); await f.panel.openTask(1)
+    assert.equal(f.panel.canUpload.value, true)
+    assert.equal(f.panel.canApplyReview.value, true)
+    await f.panel.saveDraft(); assert.equal(f.calls.filter(x => x[0] === 'apply').length, 0)
+    await f.panel.applySelected(); assert.equal(f.calls.filter(x => x[0] === 'apply').length, 1)
+    f.dispose()
+})
diff --git a/server/.env.followup-audio.example b/server/.env.followup-audio.example
index a8f78f4ec..e72e40a63 100644
--- a/server/.env.followup-audio.example
+++ b/server/.env.followup-audio.example
@@ -3,6 +3,9 @@
 [followup_audio]
 ENABLED = false
 PREVIEW_ONLY = false
+# Explicit human-reviewed business use, with an exact connection-ready provider fingerprint.
+# This never marks AUDIO_VERIFIED true or removes original preview-task markers.
+MANUAL_REVIEW_ENABLED = false
 # IDs only. Empty or invalid diagnosis allowlist denies preview; admin list never replaces RBAC.
 TEST_DIAGNOSIS_IDS =
 TEST_ADMIN_IDS =
diff --git a/server/app/adminapi/logic/tcm/FollowupAudioLogic.php b/server/app/adminapi/logic/tcm/FollowupAudioLogic.php
index e28da28b2..18fb18cf9 100644
--- a/server/app/adminapi/logic/tcm/FollowupAudioLogic.php
+++ b/server/app/adminapi/logic/tcm/FollowupAudioLogic.php
@@ -23,11 +23,13 @@ final class FollowupAudioLogic
         $ready = Store::ready();
         $enabled = Store::enabled() && $scope;
         $verified = Store::verified();
+        $manualReady = Gate::manualReviewReady();
         $daily = Access::canDaily($actor, $info);
         return [
             'enabled' => $enabled, 'audio_verified' => $verified,
+            'manual_review_enabled' => Gate::manualReviewEnabled(), 'manual_review_ready' => $manualReady,
             'preview_only' => $preview, 'preview_ready' => $preview && $ready, 'test_scope_allowed' => $scope,
-            'can_upload' => $enabled && $ready, 'can_review' => $enabled && $ready, 'can_apply' => $enabled && $verified && !$preview,
+            'can_upload' => $enabled && $ready, 'can_review' => $enabled && $ready, 'can_apply' => $enabled && ($verified || $manualReady) && !$preview,
             'can_daily' => $daily, 'limits' => Upload::limits(),
             'models' => $enabled ? ProviderConfig::readyModels() : [],
             // No migration/dictionary dependency is introduced when the feature is OFF.
diff --git a/server/app/common/service/followupaudio/FollowupAudioGate.php b/server/app/common/service/followupaudio/FollowupAudioGate.php
index 042bec383..7ffd0cf79 100644
--- a/server/app/common/service/followupaudio/FollowupAudioGate.php
+++ b/server/app/common/service/followupaudio/FollowupAudioGate.php
@@ -42,6 +42,23 @@ final class FollowupAudioGate
         if (!self::scopeAllowed($diagnosisId, $actor, $settings)) { throw new DomainException('FOLLOWUP_AUDIO_PREVIEW_SCOPE_DENIED'); }
     }
 
+    /** Explicit human-adoption operation is separate from model accuracy certification. */
+    public static function manualReviewEnabled(?array $settings = null): bool
+    {
+        return (($settings ?? (array) config('followup_audio', []))['manual_review_enabled'] ?? false) === true;
+    }
+
+    public static function manualReviewReady(?string $profile = null, ?array $settings = null, ?array $legacy = null): bool
+    {
+        $settings = $settings ?? (array) config('followup_audio', []); $legacy = $legacy ?? (array) config('prescription_ai', []);
+        if (self::previewOnly($settings) || !self::manualReviewEnabled($settings)) { return false; }
+        if ($profile === null) {
+            foreach (['qwen', 'openai'] as $slot) { if (self::manualReviewReady($slot, $settings, $legacy)) { return true; } }
+            return false;
+        }
+        return FollowupAudioProviderConfig::previewVerified($profile, $settings, $legacy);
+    }
+
     public static function ready(?string $profile = null, ?array $settings = null, ?array $legacy = null): bool
     {
         $settings = $settings ?? (array) config('followup_audio', []); $legacy = $legacy ?? (array) config('prescription_ai', []);
@@ -50,7 +67,7 @@ final class FollowupAudioGate
             return false;
         }
         return self::previewOnly($settings) ? FollowupAudioProviderConfig::previewVerified($profile, $settings, $legacy)
-            : FollowupAudioProviderConfig::verified($profile, $settings, $legacy);
+            : FollowupAudioProviderConfig::verified($profile, $settings, $legacy) || self::manualReviewReady($profile, $settings, $legacy);
     }
 
     /** Persisted preview-origin tasks never become eligible for adoption after a configuration change. */
diff --git a/server/app/common/service/followupaudio/FollowupAudioStore.php b/server/app/common/service/followupaudio/FollowupAudioStore.php
index 9ca30c6ae..2ecbc5d08 100644
--- a/server/app/common/service/followupaudio/FollowupAudioStore.php
+++ b/server/app/common/service/followupaudio/FollowupAudioStore.php
@@ -113,6 +113,9 @@ final class FollowupAudioStore
     private static function reuse(array $task, string $recordedAt): array
     {
         $message = '同一诊单、录音内容及模型已有任务，已复用原任务，不会再次调用模型。';
+        if (!FollowupAudioGate::previewOnly() && FollowupAudioGate::taskPreview($task)) {
+            $message .= '这是历史测试预览任务，保持测试用途；本次未创建业务任务，原任务不提供确认入单。';
+        }
         if (!self::providerMatches($task)) {
             $message .= '原任务的服务配置已变更或缺少配置快照，不能自动改用新服务重跑。';
         }
diff --git a/server/config/followup_audio.php b/server/config/followup_audio.php
index b946d98e3..a6322e8b2 100644
--- a/server/config/followup_audio.php
+++ b/server/config/followup_audio.php
@@ -2,6 +2,8 @@
 
 /** Audio is deliberately OFF until the synthetic short/15m/1h gate passes for the current app. */
 return [
+    // Human-reviewed business operation; does not claim complete model accuracy certification.
+    'manual_review_enabled' => filter_var(env('followup_audio.MANUAL_REVIEW_ENABLED', false), FILTER_VALIDATE_BOOLEAN),
     'preview_only' => filter_var(env('followup_audio.PREVIEW_ONLY', false), FILTER_VALIDATE_BOOLEAN),
     // Parse strictly at the gate; empty/malformed diagnosis lists never grant preview access.
     'test_diagnosis_ids' => env('followup_audio.TEST_DIAGNOSIS_IDS', ''),
diff --git a/server/tests/FollowupAudioControllerFlowTest.php b/server/tests/FollowupAudioControllerFlowTest.php
index e95cfb24e..aed87db5b 100644
--- a/server/tests/FollowupAudioControllerFlowTest.php
+++ b/server/tests/FollowupAudioControllerFlowTest.php
@@ -58,7 +58,15 @@ if (($argv[1] ?? '') === '--request') {
     exit(0);
 }
 
-$f = followupAudioTestDatabase(['preview_only' => false]);
+$manualMode = in_array('--manual-review', $argv, true);
+$f = followupAudioTestDatabase(['preview_only' => false, 'manual_review_enabled' => $manualMode,
+    'audio_verified' => !$manualMode, 'verified_profiles' => $manualMode ? [] : ['qwen']]);
+if ($manualMode) {
+    $providers = config('followup_audio.providers');
+    $providers['qwen']['preview_verified_fingerprint'] = Provider::resolve('qwen')['fingerprint'];
+    $providers['qwen']['verified_fingerprint'] = '';
+    $f['config']->set(['providers' => $providers], 'followup_audio');
+}
 $checks = 0;
 $expect = static function (bool $ok, string $why) use (&$checks): void {
     if (!$ok) { throw new RuntimeException($why); } $checks++;
@@ -169,6 +177,7 @@ try {
     } else {
     $cap = $success(followupControllerRequest('capabilities', ['diagnosis_id' => 1], 1, 'GET'), 'normal capabilities');
     $expect($cap['enabled'] && !$cap['preview_only'] && $cap['can_apply'], 'normal mode enabled only inside isolated fixture');
+    if ($manualMode) { $expect(!$cap['audio_verified'] && $cap['manual_review_enabled'] && $cap['manual_review_ready'], 'manual business does not fake model accuracy verification'); }
     $detail = $make([['diagnosis', ['symptoms' => '合成症状']], ['blood', ['fasting_blood_sugar' => 6.1]]]);
     $reject(followupControllerRequest('apply', $body($resolve($detail))), 'FOLLOWUP_AUDIO_CHANNEL_ROLES_REQUIRED');
     $initialVersion = $detail['version'];
diff --git a/server/tests/FollowupAudioManualReviewTest.php b/server/tests/FollowupAudioManualReviewTest.php
new file mode 100644
index 000000000..4c2f137f0
--- /dev/null
+++ b/server/tests/FollowupAudioManualReviewTest.php
@@ -0,0 +1,16 @@
+<?php
+declare(strict_types=1);
+require dirname(__DIR__).'/vendor/autoload.php';require dirname(__DIR__).'/vendor/topthink/framework/src/helper.php';
+use app\common\service\followupaudio\FollowupAudioGate as G;use app\common\service\followupaudio\FollowupAudioProviderConfig as P;use app\common\service\followupaudio\FollowupAudioStore as S;
+new think\App();$config=new think\Config();think\Container::getInstance()->instance('config',$config);
+$n=0;$ok=static function(bool$b,string$m)use(&$n){if(!$b)throw new RuntimeException($m);$n++;};
+$slot=['driver'=>'asr_then_llm','label'=>'Synthetic','asr'=>['protocol'=>'dify','binding_revision'=>'fixture','base_url'=>'https://asr.invalid/v1','api_key'=>'synthetic','model'=>'synthetic-asr'],'extraction'=>['base_url'=>'https://text.invalid/v1','api_key'=>'synthetic','model'=>'synthetic-text']];
+$s=['enabled'=>true,'preview_only'=>false,'manual_review_enabled'=>true,'audio_verified'=>false,'verified_profiles'=>[],'providers'=>['openai'=>$slot],'profile'=>'openai','test_diagnosis_ids'=>'1'];$p=P::resolve('openai',$s,[]);$s['providers']['openai']['preview_verified_fingerprint']=$p['fingerprint'];$config->set($s,'followup_audio');
+$ok(G::ready('openai'),'explicit manual business readiness supported');$ok(!S::verified(),'not an accuracy certification');$ok(G::manualReviewReady()&&G::manualReviewReady('openai'),'any and selected readiness');$ok(G::scopeAllowed(1131,1)&&G::scopeAllowed(12335,1),'no preview whitelist in business mode');$ok(array_column(P::readyModels(),'value')===['openai'],'only actual ready model advertised');
+foreach([false,'true',null]as$flag){$x=$s;$x['manual_review_enabled']=$flag;$ok(!G::ready('openai',$x,[]),'explicit boolean operator grant required');}
+foreach(['','different-binding']as$fp){$x=$s;$x['providers']['openai']['preview_verified_fingerprint']=$fp;$ok(!G::ready('openai',$x,[]),'binding readiness required');}
+$x=$s;$x['providers']['openai']['extraction']['model']='changed-model';$ok(!G::ready('openai',$x,[]),'model drift invalidates manual readiness');$ok(!G::manualReviewReady('qwen',$s,[]),'one profile does not grant another');
+$x=$s;$x['preview_only']=true;$config->set($x,'followup_audio');$ok(!G::manualReviewReady(),'preview dominates manual grant');$ok(!G::scopeAllowed(1131,1),'preview keeps its scoped list');try{G::assertMayApply();throw new RuntimeException('expected deny');}catch(DomainException$e){$ok($e->getMessage()==='FOLLOWUP_AUDIO_PREVIEW_ONLY','preview hard denial');}
+$config->set($s,'followup_audio');G::assertMayApply(['upstream_ids_json'=>'{}']);$ok(true,'new business task may reach human Apply');try{G::assertMayApply(['upstream_ids_json'=>'{"preview_only":true}']);throw new RuntimeException('expected origin deny');}catch(DomainException$e){$ok($e->getMessage()==='FOLLOWUP_AUDIO_PREVIEW_ONLY','old synthetic preview remains nonadoptable');}
+$x=$s;$x['manual_review_enabled']=false;$config->set($x,'followup_audio');try{S::assertEnabled('openai');throw new RuntimeException('expected revoke');}catch(DomainException$e){$ok($e->getMessage()==='FOLLOWUP_AUDIO_DISABLED_OR_UNVERIFIED','manual grant revocation stops writes and processing');}
+echo 'FOLLOWUP_AUDIO_MANUAL_REVIEW assertions='.$n.' PASS all_authorized_diagnoses=1 explicit_human_apply=1 accuracy_flag_unchanged=1 binding_required=1 preview_origin_retained=1'.PHP_EOL;